INCREDIBLE RESIDENTIAL SERVICES LLC NPI 1558233148

NPI Information

  • NPI: 1558233148
  • Provider Name: INCREDIBLE RESIDENTIAL SERVICES LLC
  • Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
  • Entity Type: Organization
  • Address: 2246 SE 90TH AVE
    PORTLAND, OR
    ZIP 97216
  • Phone: (702) 491-3964

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NPI Details

INCREDIBLE RESIDENTIAL SERVICES LLC is a community based residential treatment facility mental illness in Portland, OR. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. INCREDIBLE RESIDENTIAL SERVICES LLC NPI is 1558233148. The provider is registered as an organization entity type.

The provider's business location address is:

2246 SE 90TH AVE
PORTLAND, OR
ZIP 97216-021
Phone: (702) 491-3964
Fax: (503) 894-8787

The provider's authorized official is Gemechu Jorjore .
The authorized official title is Director and has the following contact phone number (702) 491-3964.

The enumeration date for this NPI number is 9/22/2025 and was last updated on 9/22/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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