Healthcare Provider Details

I. General information

NPI: 1548471543
Provider Name (Legal Business Name): CATHOLIC COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 PORTLAND RD NE
SALEM OR
97303-2511
US

IV. Provider business mailing address

PO BOX 20400
KEIZER OR
97307-0400
US

V. Phone/Fax

Practice location:
  • Phone: 503-390-2600
  • Fax: 503-390-8562
Mailing address:
  • Phone: 503-390-2600
  • Fax: 503-390-8562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER HUPP
Title or Position: CLINICAL SUPERVISOR
Credential: CADC II, NCAC II
Phone: 503-390-2600