Calm Haven PDX LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

CALM HAVEN PDX LLC

Practice address

711 NE 172ND Ave
Portland, OR 97230-6420

Phone

(458) 262-4514

NPI assigned

Jan 13, 2025

Last updated

Jan 13, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wilson Kisambira Kisambira

Title

Manager

Phone

(781) 309-8976

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1841000767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 NE 172ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 NE 172ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972306420",
            "telephone_number": "458-262-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALM HAVEN PDX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "KISAMBIRA",
        "authorized_official_first_name": "WILSON",
        "authorized_official_middle_name": "KISAMBIRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "781-309-8976"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric Residential Treatment Facility in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.