| Providence Addictions Recovery Ctr | |
|
1322 Commerce Ave Longview WA 98632-3718 | |
| (360) 414-8771 | |
| (360) 414-8776 |
| Full Name | Providence Addictions Recovery Ctr |
|---|---|
| Speciality | Psychologist - Addiction (substance Use Disorder) |
| Location | 1322 Commerce Ave, Longview, Washington |
| Authorized Official Name and Position | Nicole Quinn (PAYOR CREDENTIALING MANAGER) |
| Authorized Official Contact | 4255256715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Addictions Recovery Ctr Po Box 34439 Seattle WA 98124-1439 Ph: (425) 525-6778 | Providence Addictions Recovery Ctr 1322 Commerce Ave Longview WA 98632-3718 Ph: (360) 414-8771 |
| NPI Number | 1245438738 |
|---|---|
| Provider Enumeration Date | 07/05/2007 |
| Last Update Date | 12/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245438738 | NPI | - | NPPES |
| 08 0983 00 | Medicaid | WA | |
| 631762 | Other | WA | LONGVIEW BUSINESS LICENSE |
| 602 399 531 | Other | WA | UBI MASTER LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
Strengthening Foundations Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1338 Commerce Ave, 208, Longview, WA 98632 Phone: 360-703-1192 | |
Cascade Neurohealth Tms Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2738 Fir St, Longview, WA 98632 Phone: 360-560-3801 | |
Haven Mind Body Collective, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1105 15th Ave Ste F, Longview, WA 98632 Phone: 360-703-6499 | |
Santosha Therapy, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 873 Bunker Hill Rd, Longview, WA 98632 Phone: 509-389-4320 | |
Resources United Supportive Service Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 1st Ave Ste 4a, Longview, WA 98632 Phone: 520-260-4584 | |
Ally Christian Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 398 N Columbia Heights Rd, Longview, WA 98632 Phone: 360-836-0320 |