Providence Addictions Recovery Ctr
LBN: Providence Health & Service Washington
Providence Addictions Recovery Ctr is an health care organization with primary practice located at 218-A Main Street , Morton WA 98356-0000. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as the primary health care specialty.
Providence Health & Service Washington can be contacted via phone (360) 496-6216, or through Quinn, Nicole via phone (425) 525-6715.
Contact Information
Primary practice address
218-A Main Street
Morton WA 98356-0000
Phone: (360) 496-6216
Fax: (360) 496-6232
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X |
Profile Details
| NPI number | 1104024348 |
|---|---|
| LBN Legal business name | Providence Health & Service Washington |
| DBA Doing business as | Providence Addictions Recovery Ctr |
| Authorized official | Quinn, Nicole |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 10th, 2007 |
| Last updated | Dec 22nd, 2010 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104024348 | NPPES |
| Washington | Other | 602 399 531 | UBI MASTER LICENSE |
| Washington | Other | 1250 | UBI MASTER LICENSE |
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