Lilac City Behavioral | |
318 E Rowan Ave Ste 201 Spokane WA 99207-1200 | |
(509) 844-2429 | |
(509) 319-2338 |
Full Name | Lilac City Behavioral |
---|---|
Speciality | Community/behavioral Health |
Location | 318 E Rowan Ave Ste 201, Spokane, Washington |
Authorized Official Name and Position | Jeffrey Stan Kalles (CEO/MEMBER) |
Authorized Official Contact | 5098444966 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lilac City Behavioral 318 E Rowan Ave Ste 201 Spokane WA 99207-1200 Ph: (509) 844-2429 | Lilac City Behavioral 318 E Rowan Ave Ste 201 Spokane WA 99207-1200 Ph: (509) 844-2429 |
NPI Number | 1386195279 |
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Provider Enumeration Date | 10/17/2016 |
Last Update Date | 07/21/2020 |
Certification Date | 07/21/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386195279 | NPI | - | NPPES |
2080619 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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