| Pope's Kids Place | |
|
230 Washington Way Centralia WA 98531-9325 | |
| (360) 736-9178 | |
| (360) 736-8312 |
| Full Name | Pope's Kids Place |
|---|---|
| Speciality | Home Health |
| Location | 230 Washington Way, Centralia, Washington |
| Authorized Official Name and Position | Angela Dickson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3607369178 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pope's Kids Place 230 Washington Way Centralia WA 98531-9225 Ph: (360) 736-9178 | Pope's Kids Place 230 Washington Way Centralia WA 98531-9325 Ph: (360) 736-9178 |
| NPI Number | 1154535771 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 11/21/2022 |
| Certification Date | 11/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154535771 | NPI | - | NPPES |
| 7123508 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0015X | Psychiatry & Neurology - Psychosomatic Medicine | (* (Not Available)) | Secondary |
| 251E00000X | Home Health | (* (Not Available)) | Primary |
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