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503 Knight St Ste B Richland WA 99352-4257 | |
| (509) 943-8484 | |
| (509) 943-8483 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 503 Knight St Ste B, Richland, Washington |
| Authorized Official Name and Position | Jim Mason (ADMINISTRATOR) |
| Authorized Official Contact | 5099438484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
503 Knight St Ste B Richland WA 99352-4257 Ph: (509) 943-8484 | 503 Knight St Ste B Richland WA 99352-4257 Ph: (509) 943-8484 |
| NPI Number | 1225361900 |
|---|---|
| Provider Enumeration Date | 09/11/2009 |
| Last Update Date | 09/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225361900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 03144600 (Washington) | Primary |
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