NPIMap

Organization Active NPI

Renaissance Recovery Resources, Inc.

  • Community/Behavioral Health Agency
  • Salem, OR
National Provider Identifier
1982017992
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
RENAISSANCE RECOVERY RESOURCES, INC.
Practice address
465 Commercial St NE Ste 150
Salem, OR 97301-3414
Phone
(503) 362-2780
Fax
(503) 362-2768
NPI assigned
Jun 6, 2014
Organization subpart
Yes
Parent organization
RENAISSANCE RECOVERY RESOURCES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Justin Scott Nielsen, CADC II
Title
Executive Director
Phone
(503) 304-4358

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

465 Commercial St NE Ste 150
Salem, OR 97301-3414

Mailing address

PO Box 20674
Keizer, OR 97307-0674
Phone (503) 304-4358

Other names 1

  • Oregon Recovery Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Renaissance Recovery Resources Inc7 organizations share this tax ID, including this one
Part of
Renaissance Recovery Resources Inc

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

465 Commercial St NE
Ste 150
Salem, OR 97301
Phone (503) 304-4358

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1982017992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20674",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973070674",
            "telephone_number": "503-304-4358",
            "fax_number": "503-304-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 COMMERCIAL ST NE STE 150",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013414",
            "telephone_number": "503-362-2780",
            "fax_number": "503-362-2768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE RECOVERY RESOURCES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RENAISSANCE RECOVERY RESOURCES, INC.",
        "enumeration_date": "2014-06-06",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "503-304-4358",
        "authorized_official_credential": "CADC II"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oregon Recovery Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.