| |
12201 Pacific Ave S Tacoma WA 98444-5126 | |
(253) 536-6425 | |
(253) 536-6637 |
Full Name | |
---|---|
Speciality | Community/behavioral Health |
Location | 12201 Pacific Ave S, Tacoma, Washington |
Authorized Official Name and Position | Magdalen Gustilo (DIRECTOR OF PAYER RELATIONS) |
Authorized Official Contact | 7145687667 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
18401 Von Karman Ave Ste 500 Irvine CA 92612-8531 Ph: (714) 828-1800 | 12201 Pacific Ave S Tacoma WA 98444-5126 Ph: (253) 536-6425 |
NPI Number | 1750821781 |
---|---|
Provider Enumeration Date | 02/23/2017 |
Last Update Date | 01/02/2024 |
Certification Date | 01/02/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750821781 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 168900 (Washington) | Primary |
Sankofa Mental Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1925 Westridge Ave W # A, Tacoma, WA 98466 Phone: 253-348-3536 Fax: 253-954-1890 | |
Grit City Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3121 S 7th St, Tacoma, WA 98405 Phone: 253-302-4639 | |
Imagine Behavioral And Developmental Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9720 S Tacoma Way, Tacoma, WA 98499 Phone: 253-682-0320 |