| Community House On Broadway | |
|
748 14th Ave Longview WA 98632-2315 | |
| (360) 200-5419 | |
| Not Available |
| Full Name | Community House On Broadway |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 748 14th Ave, Longview, Washington |
| Authorized Official Name and Position | Cameron Carson (CLINIC MANAGER) |
| Authorized Official Contact | 3602005419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community House On Broadway Po Box 403 Longview WA 98632-7260 Ph: (360) 200-5419 | Community House On Broadway 748 14th Ave Longview WA 98632-2315 Ph: (360) 200-5419 |
| NPI Number | 1467855353 |
|---|---|
| Provider Enumeration Date | 10/06/2014 |
| Last Update Date | 10/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467855353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 313 (Washington) | Primary |
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