| NPI | 1477563344 |
|---|---|
| Doing Business As | PROVIDENCE KODIAK ISLAND COUNSELING CENTER |
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secretary Of Enrollments 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AK 297340) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AK 297340) |
| 171M00000X Case Manager/Care Coordinator (Licence: AK 297340) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AK 297340) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AK 297340) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2025-05-15 |