Healthcare Provider Details
I. General information
NPI: 1780771238
Provider Name (Legal Business Name): THE CENTER FOR ALCOHOL AND DRUG TREATMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2006
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
327 OKANOGAN AVE
WENATCHEE WA
98801-2970
US
IV. Provider business mailing address
327 OKANOGAN AVE
WENATCHEE WA
98801-2970
US
V. Phone/Fax
- Phone: 509-662-9673
- Fax: 509-662-9441
- Phone: 509-662-9673
- Fax: 509-662-9441
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | RTF1005 |
| License Number State | WA |
VIII. Authorized Official
Name: MS.
JANICE
K
SANFORD
Title or Position: ACCOUNTS RECEIVABLE
Credential:
Phone: 509-662-9673