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General NPI Number Information
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NPI Number | 1821382870
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Entity Type | Organization
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Legal Business Name | ASIAN AMERICAN CHEMICAL DEPENDENCY TREATMENT SERVICES
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 4629 168TH ST SW STE E
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City | LYNNWOOD
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State | WA
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Zip | 98037-8640
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Country | US
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Telephone | 425-776-1290
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Fax | 425-776-1298
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Provider Business Mailing Address
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Address Line | 9100 BRIDGEPORT WAY SW
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City | LAKEWOOD
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State | WA
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Zip | 98499-2427
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Country | US
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Telephone | 253-302-3826
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Fax | 253-267-5212
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TAE SON LEE
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Credential | CDP
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Telephone | 253-302-3826
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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 | 31130100
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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 | 31130100
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License Number State | WA
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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 | 31130100
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License Number State | WA
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