NPI 1043933617

Department of Social and Health Services

Organisation Mental Illness Community Based Residential Treatment Facility Centralia, WA

Practice location

Address: 20413 Old Hwy 9 SW, Centralia, WA 98531
Phone: (360) 999-7678
Mailing address: PO Box 45861, Olympia, WA 98504-5861

Authorised official

Name: Melissa Tengowski
Title: Qaim
Phone: (360) 999-3851

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in Washington →

Registry record

NPI: 1043933617
Entity type: Organization
NPI issued: 20 Sep 2022
Record last updated: 20 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.