Alcohol Drug Dependency Service

NPI 1043332133 - Clinic/Center - 261QR0405X

NPI Details
NPI 1043332133
Enumeration Date 04/06/2007
Last Updated 02/27/2016
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DAVID L DAVID
Position EXECUTIVE DIRECTOR
Phone (509) 925-9821
Fax (509) 963-3941
Practice Location
507 N NANUM ST RM 30
ELLENSBURG WA, 98926-2886, US
Phone (509) 925-9821
Fax (509) 963-3941
Business Location
507 N NANUM ST RM 30
ELLENSBURG WA, 98926-2886, US
Phone (509) 925-9821
Fax (509) 963-3941
Toxanomy
Taxonomy Code 261QR0405X
License State Washington
License Number 19 0071 00
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According to our database, Alcohol Drug Dependency Service NPI is 1043332133, taxonomy code is 261QR0405X and license number is 19 0071 00, license state is located at Washington. Alcohol Drug Dependency Service physically located at 507 N Nanum St Rm 30, Ellensburg WA, 98926-2886. NPI Number 1033115704 has the healthcare provider type.

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1043332133 NPI number is provided on an as is basis without warranty of any kind. 1043332133 is maintained by the National Plan & Provider Enumeration System. The contents of Alcohol Drug Dependency Service are for informational purposes only.