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General NPI Number Information
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NPI Number | 1467933069
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Entity Type | Organization
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Legal Business Name | WASHINGTON BLOCK, LLC
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 1215 LINCOLN ST
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City | OROVILLE
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State | CA
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Zip | 95965-4810
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Country | US
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Telephone | 530-854-4959
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Fax | 530-854-4902
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Provider Business Mailing Address
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Address Line | PO BOX 6205
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City | OROVILLE
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State | CA
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Zip | 95966-1205
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Country | US
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Telephone | 530-854-4959
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Fax | 530-854-4902
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MR. JIM M WARD
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Credential | AOD COUNSELOR
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Telephone | 530-854-4959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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