Healthcare Provider Details

I. General information

NPI: 1750581070
Provider Name (Legal Business Name): TRI-CITIES COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 W COURT ST
PASCO WA
99301
US

IV. Provider business mailing address

PO BOX 1452
PASCO WA
99301
US

V. Phone/Fax

Practice location:
  • Phone: 509-545-6506
  • Fax: 509-546-0520
Mailing address:
  • Phone: 509-547-2204
  • Fax: 509-542-8836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: KRISTY NEEDHAM
Title or Position: CEO
Credential:
Phone: 509-547-2204