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General NPI Number Information
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NPI Number | 1184159816
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Entity Type | Organization
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Legal Business Name | NEW PHOEBE HOUSE ASSOCIATION
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 1001 YAKIMA AVE STE 14
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City | TACOMA
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State | WA
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Zip | 98405-4869
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Country | US
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Telephone | 253-267-5402
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Fax | 253-328-7301
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Provider Business Mailing Address
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Address Line | 712 MARTIN LUTHER KING JR WAY PO BOX 5245
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City | TACOMA
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State | WA
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Zip | 98405-4138
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Country | US
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Telephone | 253-383-7710
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | RENA KAY THOMPSON
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Credential |
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Telephone | 253-433-2321
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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 | 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 #3
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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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