Organization Name: | COLVILLE CONFEDERATED TRIBES |
NPI Number: | 1841418977 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA PAYNE (OFFICE MANAGER) |
Mailing Address: | 1 Colville Street Nespelem |
State: | WA US |
Postal Code: | 991550150 |
Phone Number: | 5096342727 |
Fax Number: | 5096342781 |
NPI Enumeration Date: | 04/23/2007 |
NPI Last Update Date: | 10/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0405X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
Taxonomy Definition: |