MEDICARE: KENT YOUTH AND FAMILY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center		WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932399359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENT YOUTH AND FAMILY SERVICES

Provider Business Mailing Address
First Line	:	232 2ND AVE S
Second Line	:	STE 201
City	:	KENT
State	:	WA
Zip	:	98032-5862
Country	:	US
Telephone Number	:	253-859-0300
Fax Number	:	253-859-0745

Provider Business Practice Location Address
First Line	:	232 2ND AVE S
Second Line	:	STE 201
City	:	KENT
State	:	WA
Zip	:	98032-5862
Country	:	US
Telephone Number	:	253-859-0300
Fax Number	:	253-859-0745

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. MICHAEL E HEINISCH
Credential	:	M.C.,N.C.C.
Telephone Number	:	253-859-0300

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	08/01/2007

Similar Medicare Providers

1093438392 — RACHEL HECKROTH CO61535441
Practice Location Address:

232 2ND AVE S
KENT, WA
98032-5862

Practice Phone: 253-859-0300
Practice Fax:

1487290490 — ARELI GUTIERREZ GONZALEZ
Practice Location Address:

232 2ND AVE S STE 201
KENT, WA
98032-5862

Practice Phone: 253-859-0300
Practice Fax:

1164389318 — ANDREW RICHARD TRINIDAD
Practice Location Address:

232 2ND AVE S STE 201
KENT, WA
98032-5862

Practice Phone: 253-859-0300
Practice Fax:

1285837849 — KENT YOUTH AND FAMILY SERVICES
Practice Location Address:

232 2ND AVE S , SUITE 201
KENT, WA
98032-5862

Practice Phone: 253-859-0300
Practice Fax: 253-859-0745

1568651529 — BRUCE HINSDALE LW
Practice Location Address:

232 2ND AVE S STE 201
KENT, WA
98032-5862

Practice Phone: 253-859-0300
Practice Fax: 253-859-0745

1528243375 — MRS. JENNIFER WAGNER LMHC, SUDPT
Practice Location Address:

232 2ND AVE S STE 201
KENT, WA
98032-5862

Practice Phone: 253-859-0300
Practice Fax: 253-859-0745

Directions to “KENT YOUTH AND FAMILY SERVICES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.