Healthcare Provider Details

I. General information

NPI: 1285634675
Provider Name (Legal Business Name): CATHOLIC CHILDREN & FAMILY SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 W POPLAR ST
WALLA WALLA WA
99362-2831
US

IV. Provider business mailing address

408 W POPLAR ST
WALLA WALLA WA
99362-2831
US

V. Phone/Fax

Practice location:
  • Phone: 509-525-0572
  • Fax: 509-525-0576
Mailing address:
  • Phone: 509-525-0572
  • Fax: 509-525-0576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateWA

VIII. Authorized Official

Name: MR. RICHARD A GARCIA
Title or Position: DIRECTOR
Credential: MSW
Phone: 509-525-0572