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Addiction Substance Use Disorder

Othello, Washington

Provider NPI: 1407855653

Organization Information:
Organization Name:  COUNTY OF ADAMS
Organization is not Subpart
Authorized Official:  VICKI  GUSE  ADMINISTRATOR  509-4884074

Practice Location:
425 E MAIN ST STE 600  OTHELLO, WA 99344 US
Tel: 509-488-4074  Fax: 509-488-0166

Business Mailing Address:
425 E MAIN ST STE 600  OTHELLO, WA 99344 US
Tel: 509-488-4074  Fax: 509-488-0166

Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Addiction (Substance Use Disorder)
N101YM0800XBehavioral Health & Social Service Providers
N171M00000XOther Service Providers
Case Manager/Care Coordinator
Community/Behavioral Health

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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