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2002 156th Ave Ne Bellevue WA 98007 | |
| (800) 682-6934 | |
| (888) 788-3419 |
| Full Name | |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 2002 156th Ave Ne, Bellevue, Washington |
| Authorized Official Name and Position | Cosette Dawna Rae (CEO) |
| Authorized Official Contact | 8006826934 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1001 290th Ave Se Fall City WA 98024-7403 Ph: (800) 682-6934 | 2002 156th Ave Ne Bellevue WA 98007 Ph: (800) 682-6934 |
| NPI Number | 1801166103 |
|---|---|
| Provider Enumeration Date | 01/04/2012 |
| Last Update Date | 04/19/2022 |
| Certification Date | 04/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801166103 | NPI | - | NPPES |
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