Healthcare Provider Details

I. General information

NPI: 1649316316
Provider Name (Legal Business Name): THE VALLEY ALCOHOL COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 02/26/2022
Certification Date: 02/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 W 1ST AVE
TOPPENISH WA
98948-1527
US

IV. Provider business mailing address

PO BOX 336
TOPPENISH WA
98948-0366
US

V. Phone/Fax

Practice location:
  • Phone: 509-865-5233
  • Fax: 509-865-6505
Mailing address:
  • Phone: 509-865-5233
  • Fax: 509-865-6505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number014101
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number014101
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. SHEREEN HUNT
Title or Position: EXECUTIVE DIRECTOR
Credential: SUDP
Phone: 509-837-7700