FDS ALLIANCE RESIDENTIAL LLC – NPI #1407707805
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

FDS ALLIANCE RESIDENTIAL LLC is a community based residential treatment facility located in PORTLAND, OR. NPPES has assigned the NPI number 1407707805 to FDS ALLIANCE RESIDENTIAL LLC on February 03, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FDS ALLIANCE RESIDENTIAL LLC below.

NPI Profile for
FDS ALLIANCE RESIDENTIAL LLC

NPI Number
1407707805
Enumeration Date

(about 4 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
FDS ALLIANCE RESIDENTIAL LLC
Primary location
380 NE 178TH AVE
PORTLAND, OR 97230-6658
Phone: (971) 431-6436 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
GEMECHIS ABDISSA
MANAGING MEMBER
Phone: (971) 431-6436
Updated
Certification Date
Feb 03, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.