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General NPI Number Information
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NPI Number | 1326829433
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Entity Type | Organization
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Legal Business Name | CRITICAL TIME INTERVENTION PIERCE COUNTY
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Dates
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Enumeration Date | 10/13/2023
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 1201 PACIFIC AVE STE 600
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City | TACOMA
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State | WA
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Zip | 98402-4384
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Country | US
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Telephone | 253-348-3742
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Fax |
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Provider Business Mailing Address
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Address Line | 17110 31ST ST NW
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City | LAKEBAY
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State | WA
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Zip | 98349-8536
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Country | US
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Telephone | 253-348-3742
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | LISA LYENTTE KLEINER
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Credential | BA
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Telephone | 253-348-3742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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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