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NOOKSACK CENTRAL MANAGEMENT SYSTEM NPI 1891909867


NPI Information

NPI: 1891909867
Provider Name: NOOKSACK CENTRAL MANAGEMENT SYSTEM

Other Name: THE NOOKSACK HOPE CHEMICAL DEPENDENCY PROGRAM

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
6750 MISSION RD
EVERSON, WA
ZIP 98247
Phone: (360) 966-7704
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NOOKSACK CENTRAL MANAGEMENT SYSTEM is a substance abuse rehabilitation facility in Everson, WA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. NOOKSACK CENTRAL MANAGEMENT SYSTEM NPI is 1891909867. The provider is registered as an organization entity type.
The provider Other Name Is The Nooksack Hope Chemical Dependency Program.

The provider's business location address is:

6750 MISSION RD
EVERSON, WA
ZIP 98247-749
Phone: (360) 966-7704
Fax: (360) 966-4225

The provider's authorized official is Eric R. Davenport .
The authorized official title is Governmental Service Exec. and has the following contact phone number (360) 592-5176.

The enumeration date for this NPI number is 5/9/2007 and was last updated on 9/9/2011.


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 FacilityWASHINGTONYes

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
11993666MEDICAIDWASHINGTON
21993013MEDICAIDWASHINGTON

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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