Providence Addictions Recovery Ctr
LBN: Providence Health & Service Washington
Providence Addictions Recovery Ctr is an health care organization with primary practice located at 1322 Commerce Ave , Longview WA 98632-3718. 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) 414-8771, or through Quinn, Nicole via phone (425) 525-6715.
Contact Information
Primary practice address
1322 Commerce Ave
Longview WA 98632-3718
Phone: (360) 414-8771
Fax: (360) 414-8776
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X |
Profile Details
| NPI number | 1245438738 |
|---|---|
| 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 5th, 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 | 1245438738 | NPPES |
| Washington | MEDICAID | 08 0983 00 | |
| Washington | Other | 631762 | |
| Washington | Other | 602 399 531 |
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