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CONFEDERATED TRIBES OF THE COLVILLE RESERVATION NPI 1841418977


NPI Information

NPI: 1841418977
Provider Name: CONFEDERATED TRIBES OF THE COLVILLE RESERVATION

Doing Business As: ALCOHOL PROGRAM

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
21 COLVILLE STREET
NESPELEM, WA
ZIP 99155
Phone: (509) 634-2783
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CONFEDERATED TRIBES OF THE COLVILLE RESERVATION is a rehabilitation and substance use disorder clinic center in Nespelem, WA. CONFEDERATED TRIBES OF THE COLVILLE RESERVATION NPI is 1841418977. The provider is registered as an organization entity type.
The provider Is Doing Business As Alcohol Program.

The provider's business location address is:

21 COLVILLE STREET
NESPELEM, WA
ZIP 99155-150
Phone: (509) 634-2783
Fax: (509) 634-2781

The provider's authorized official is Amy Church .
The authorized official title is Revenue Cycle Manager and has the following contact phone number (509) 634-2783.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 10/5/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityNo
2261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11992957MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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