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General NPI Number Information
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NPI Number | 1598103624
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Entity Type | Organization
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Legal Business Name | CENTER FOR HUMAN SERVICES
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 18414 103RD AVE NE
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City | BOTHELL
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State | WA
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Zip | 98011-3410
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Country | US
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Telephone | 206-362-7282
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Fax | 206-362-7152
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Provider Business Mailing Address
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Address Line | 17018 15TH AVE NE
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City | SHORELINE
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State | WA
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Zip | 98155-5126
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Country | US
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Telephone | 206-362-7282
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Fax | 206-362-7152
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BERATTA GOMILLION
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Credential |
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Telephone | 206-362-7282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 17153800
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 17153800
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License Number State | WA
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