| The Nooksack Hope Behavioral Health Program | |
|
6760 Mission Rd Everson WA 98247-9749 | |
| (360) 966-4150 | |
| (360) 966-4111 |
| Full Name | The Nooksack Hope Behavioral Health Program |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 6760 Mission Rd, Everson, Washington |
| Authorized Official Name and Position | Eric R Davenport (GOVERNMENTAL SERVICE EXECUTIVE) |
| Authorized Official Contact | 3605925176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Nooksack Hope Behavioral Health Program Po Box 157 Deming WA 98244-0157 Ph: (360) 966-4150 | The Nooksack Hope Behavioral Health Program 6760 Mission Rd Everson WA 98247-9749 Ph: (360) 966-4150 |
| NPI Number | 1578778189 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 10/03/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578778189 | NPI | - | NPPES |
| 1981018 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Washington) | Primary |
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