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General NPI Number Information
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NPI Number | 1477419869
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Entity Type | Organization
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Legal Business Name | ABHS PORT ANGELES OUTPATIENT PROGRAM
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 1108 E 1ST ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-4317
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Country | US
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Telephone | 509-232-5766
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Fax |
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Provider Business Mailing Address
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Address Line | 15404 E SPRINGFIELD AVE
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City | SPOKANE VALLEY
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State | WA
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Zip | 99037-8569
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Country | US
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Telephone | 253-227-3802
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANTHONY PRENTICE
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Credential |
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Telephone | 360-507-8028
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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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