| Arubah House I Inc | |
|
144 Railroad Ave Ste 226 Edmonds WA 98020-4100 | |
| (206) 605-2021 | |
| Not Available |
| Full Name | Arubah House I Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 144 Railroad Ave Ste 226, Edmonds, Washington |
| Authorized Official Name and Position | Melissa Phares (VICE PRESIDENT) |
| Authorized Official Contact | 2066052021 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arubah House I Inc 22512 91st Ave W Edmonds WA 98026-8239 Ph: () - | Arubah House I Inc 144 Railroad Ave Ste 226 Edmonds WA 98020-4100 Ph: (206) 605-2021 |
| NPI Number | 1639771181 |
|---|---|
| Provider Enumeration Date | 11/10/2020 |
| Last Update Date | 07/10/2023 |
| Certification Date | 07/10/2023 |
| Medicare PECOS PAC ID | 2163866468 |
|---|---|
| Medicare Enrollment ID | O20240214002857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639771181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Melissa Miranda Phares |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700332962 PECOS PAC ID: 8426492729 Enrollment ID: I20240214002998 |
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