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General NPI Number Information
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NPI Number | 1619068624
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Entity Type | Organization
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Legal Business Name | CASCADE COMMUNITY HEALTHCARE
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 2428 W REYNOLDS AVE
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City | CENTRALIA
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State | WA
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Zip | 98531
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Country | US
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Telephone | 360-330-9044
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Fax |
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Provider Business Mailing Address
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Address Line | 2428 W REYNOLDS AVE
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City | CENTRALIA
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State | WA
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Zip | 98531-4554
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Country | US
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Telephone | 360-330-9044
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Fax | 360-736-3139
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Authorized Official
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Title or Position | CREDENTIALING
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Name | PAMELA TRUMBLE
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Credential |
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Telephone | 360-330-9044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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