| Reform Recovery | |
|
220 Evergreen Rd Kelso WA 98626-9705 | |
| (360) 431-0763 | |
| Not Available |
| Full Name | Reform Recovery |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 220 Evergreen Rd, Kelso, Washington |
| Authorized Official Name and Position | Amber Delagrange (OWNER) |
| Authorized Official Contact | 3604310763 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reform Recovery 220 Evergreen Rd Kelso WA 98626-9705 Ph: (360) 431-0763 | Reform Recovery 220 Evergreen Rd Kelso WA 98626-9705 Ph: (360) 431-0763 |
| NPI Number | 1154180131 |
|---|---|
| Provider Enumeration Date | 03/13/2024 |
| Last Update Date | 03/13/2024 |
| Certification Date | 03/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154180131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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