Healthcare Provider Details

I. General information

NPI: 1598109407
Provider Name (Legal Business Name): SPOKANE ADDICTION RECOVERY CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S WALNUT ST
SPOKANE WA
99204-3320
US

IV. Provider business mailing address

812 S WALNUT ST
SPOKANE WA
99204-3326
US

V. Phone/Fax

Practice location:
  • Phone: 509-624-5228
  • Fax: 509-624-7620
Mailing address:
  • Phone: 509-624-3251
  • Fax: 509-624-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number283
License Number StateWA

VIII. Authorized Official

Name: MR. MARK R BROWNLOW
Title or Position: EXECUTIVE DIRECTOR
Credential: BA, CDP
Phone: 509-624-3251