A Change Into Recovery, LLC
Community/Behavioral Health in Puyallup, WA. Organization (NPI-2).
NPI number1386019727
StatusActive
Last updated in NPPESDec 10, 2015
Details
- NPI
- 1386019727
- Entity type
- Organization (NPI-2)
- Legal business name
- A Change Into Recovery, LLC
- Organization subpart
- No
- Enumeration date
- Dec 10, 2015
- Last updated
- Dec 10, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | CP00002706 | WA | Yes |
Practice location
719 E MainSuite C
Puyallup, WA 98372-3306
Phone 253-841-8165 · Fax 253-841-8168
Mailing address
719 E MainSuite C
Puyallup, WA 98372-3306
Phone 253-841-8165 · Fax 253-841-8168
Authorized official
Dave Harris
Administrator
2538418165
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