| Full Name | |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 312 W 2nd St, Wapato, Washington |
| Authorized Official Name and Position | Shereen Hunt (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5098377700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1067 Wapato WA 98951-5067 Ph: (509) 877-7271 | 312 W 2nd St Wapato WA 98951-1110 Ph: (509) 877-7271 |
| NPI Number | 1811033582 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 02/26/2022 |
| Certification Date | 02/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811033582 | NPI | - | NPPES |
| 1019468 | Medicaid | WA | |
| BHA.FS.60873168 | Other | WA | DOH LICENSE |