Healthcare Provider Details

I. General information

NPI: 1548306210
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

315 N 2ND ST
YAKIMA WA
98901-2334
US

IV. Provider business mailing address

PO BOX 376
YAKIMA WA
98907-0376
US

V. Phone/Fax

Practice location:
  • Phone: 509-469-9366
  • Fax: 509-469-9926
Mailing address:
  • Phone: 509-469-9366
  • Fax: 509-469-9926

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 Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number39 1078 00
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateWA

VIII. Authorized Official

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