Healthcare Provider Details

I. General information

NPI: 1942518865
Provider Name (Legal Business Name): PASSAGES FAMILY SUPPORT A NONPROFIT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S ASSEMBLY ST STE 300
SPOKANE WA
99224-2116
US

IV. Provider business mailing address

1700 S ASSEMBLY ST STE 300
SPOKANE WA
99224-2116
US

V. Phone/Fax

Practice location:
  • Phone: 509-892-9241
  • Fax: 509-892-9251
Mailing address:
  • Phone: 509-892-9241
  • Fax: 509-892-9251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number235
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. REBECCA A HAMMILL
Title or Position: EXECUTIVE DIRECTOR
Credential: LICSW
Phone: 509-998-5692