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General NPI Number Information
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NPI Number | 1578864880
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Entity Type | Organization
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Legal Business Name | CONSUMER VOICES ARE BORN
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Dates
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Enumeration Date | 11/03/2010
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Last Update Date | 01/19/2017
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Provider Practice Location Address
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Address Line | 1601 E 4TH PLAIN BLVD BLDG 17, STE A114
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City | VANCOUVER
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State | WA
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Zip | 98661-3713
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Country | US
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Telephone | 360-397-8050
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Fax | 360-397-8059
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Provider Business Mailing Address
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Address Line | PO BOX 1707
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City | VANCOUVER
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State | WA
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Zip | 98668-1707
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Country | US
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Telephone | 360-397-8050
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Fax | 360-397-8059
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. BRAD BERRY
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Credential | MDIV.
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Telephone | 360-397-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 200133
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License Number State | WA
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