| NPI | 1023550050 |
|---|---|
| Doing Business As | PROVIDENCE COMMUNITY CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | DONALD ANDERSON Director Reimbursement Administrati 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA 313007977) |
| 103T00000X Psychologist (Licence: WA 313007977) | |
| 103TC0700X Psychologist, Clinical (Licence: WA 313007977) | |
| 104100000X Social Worker (Licence: WA 313007977) | |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2022-02-15 |