14114 Spokane Detox LLC
Organization Active NPI Psychiatric Residential Treatment Facility · Spokane Valley, WA
NPI 1013608801 · NPPES record last updated Jun 18, 2025
Key facts
- NPI
- 1013608801
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Residential Treatment Facility 323P00000X
- Legal business name
- 14114 SPOKANE DETOX LLC
- Practice address
- 14114 E 3Rd Ave
Spokane Valley, WA 99216-2102 - Phone
- (561) 222-1719
- NPI assigned
- May 15, 2023
- Organization subpart
- No
Authorized official
- Name
- Alexandra Korotkevich
- Title
- Executive
- Phone
- (561) 222-1719
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D2275639 | We Level Up Washington | Certificate of waiver | Apr 4, 2028 |
National Provider Directory
Locations
14114 E 3rd Ave
Spokane Valley, WA 99216
Phone (561) 222-1719
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Residential Treatment Facility | 323P00000X | Yes | ||
| Substance Abuse Rehabilitation Facility | 324500000X |
Addresses
Primary practice location
14114 E 3Rd Ave
Spokane Valley, WA 99216-2102
Mailing address
1701 Green Rd Ste C
Deerfield Beach, FL 33064-1074
Other names
- We Level Up Washington
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All providers in Spokane Valley, WA · Psychiatric Residential Treatment Facility in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.