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General NPI Number Information
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NPI Number | 1043332133
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Entity Type | Organization
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Legal Business Name | THE VALLEY ALCOHOL COUNCIL
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 02/26/2022
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Provider Practice Location Address
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Address Line | 200 E 3RD AVE
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City | ELLENSBURG
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State | WA
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Zip | 98926-3347
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Country | US
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Telephone | 509-925-9821
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Fax | 509-925-9073
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Provider Business Mailing Address
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Address Line | PO BOX 1039
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City | ELLENSBURG
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State | WA
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Zip | 98926-1926
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Country | US
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Telephone | 509-925-9821
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Fax | 509-963-3941
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. SHEREEN HUNT
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Credential | SUDP
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Telephone | 509-837-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 19 1740 00
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License Number State | WA
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