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727 N Tower Ave Centralia WA 98531-4754 | |
| (360) 827-0264 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 727 N Tower Ave, Centralia, Washington |
| Authorized Official Name and Position | Patricia Marie Howard (ASSOCIATE PASTOR/SUPERVISOR) |
| Authorized Official Contact | 3608271537 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 144 Centralia WA 98531-0144 Ph: () - | 727 N Tower Ave Centralia WA 98531-4754 Ph: (360) 827-0264 |
| NPI Number | 1699365890 |
|---|---|
| Provider Enumeration Date | 01/21/2021 |
| Last Update Date | 09/12/2023 |
| Certification Date | 09/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699365890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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