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General NPI Number Information
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NPI Number | 1669562047
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Entity Type | Organization
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Legal Business Name | FERRY COUNTY COUNSELING SERVICES
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 147 N. CLARK AVE #12
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City | REPUBLIC
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State | WA
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Zip | 99166
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Country | US
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Telephone | 509-775-2958
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Fax | 509-775-2937
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Provider Business Mailing Address
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Address Line | 42 KLONDIKE RD
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City | REPUBLIC
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State | WA
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Zip | 99166-9701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. BOB SCHWARTZ
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Credential |
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Telephone | 509-775-2958
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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 |
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License Number State |
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