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General NPI Number Information
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NPI Number | 1053839332
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Entity Type | Organization
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Legal Business Name | AMERICAN INDIAN COMMUNITY CENTER
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 1025 W INDIANA AVE
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City | SPOKANE
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State | WA
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Zip | 99205-4561
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Country | US
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Telephone | 509-534-0886
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Fax | 509-487-4264
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Provider Business Mailing Address
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Address Line | 610 E NORTH FOOTHILLS DR
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City | SPOKANE
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State | WA
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Zip | 99207-2160
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Country | US
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Telephone | 509-534-0886
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Fax |
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Authorized Official
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Title or Position | PROGRAM COORDINATOR
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Name | MRS. LINDA LAUCH
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Credential |
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Telephone | 509-535-0886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health 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 | 251B00000X
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Taxonomy Name | Case Management Agency
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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 |
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License Number State |
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Taxonomy #4
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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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