| Colville Confederated Tribes | |
|
1 Colville Street Nespelem WA 99155-0150 | |
| (509) 634-2433 | |
| (509) 634-2781 |
| Full Name | Colville Confederated Tribes |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1 Colville Street, Nespelem, Washington |
| Authorized Official Name and Position | Martha Holliday (HEALTH AND HUMAN SERVICE DIRECTOR) |
| Authorized Official Contact | 5096342433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colville Confederated Tribes 1 Colville Street Nespelem WA 99155-0150 Ph: (509) 634-2433 | Colville Confederated Tribes 1 Colville Street Nespelem WA 99155-0150 Ph: (509) 634-2433 |
| NPI Number | 1174625446 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 07/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174625446 | NPI | - | NPPES |
| 8027476 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Mental Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 21 Colville Street, Nespelem, WA 99155 Phone: 509-634-2783 Fax: 509-634-2781 |