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COUNTY OF ADAMS

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

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
N101YM0800XBehavioral Health & Social Service Providers
Counselor
N171M00000XOther Service Providers
Case Manager/Care Coordinator
N175T00000X
Y251S00000XAgencies
Community/Behavioral Health

Other Provider Identifiers:

IssuerNumberStateType
1981745WA05
1990589WA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







ADDICTION JOBS WA - Page 1



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