| A Change Into Recovery, Llc | |
|
719 E Main Suite C Puyallup WA 98372-3306 | |
| (253) 841-8165 | |
| (253) 841-8168 |
| Full Name | A Change Into Recovery, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 719 E Main, Puyallup, Washington |
| Authorized Official Name and Position | Dave Harris (ADMINISTRATOR) |
| Authorized Official Contact | 2538418165 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Change Into Recovery, Llc 719 E Main Suite C Puyallup WA 98372-3306 Ph: (253) 841-8165 | A Change Into Recovery, Llc 719 E Main Suite C Puyallup WA 98372-3306 Ph: (253) 841-8165 |
| NPI Number | 1386019727 |
|---|---|
| Provider Enumeration Date | 12/10/2015 |
| Last Update Date | 12/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386019727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CP00002706 (Washington) | Primary |
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