Great Rivers Behavioral Health Administrative Services Org

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GREAT RIVERS BEHAVIORAL HEALTH ADMINISTRATIVE SERVICES ORG

Practice address

1723 Kresky Ave
Centralia, WA 98531

Phone

(800) 215-4460

Fax

(855) 936-1291

NPI assigned

Sep 24, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Trinidad I Medina

Title

Chief Executive Director

Phone

(253) 336-3237

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1043861743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320210",
            "telephone_number": "800-215-4460",
            "fax_number": "855-936-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 KRESKY AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "800-215-4460",
            "fax_number": "855-936-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVERS BEHAVIORAL HEALTH ADMINISTRATIVE SERVICES ORG",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-24",
        "last_updated": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "TRINIDAD",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "253-336-3237",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Matthew Gove
• Graceful Healing Naturopathic
• Janet Eileen Granger, RPH
• Bruce Huntly Grant
• Chala Gray
• Jennifer Green, PA
• Melinda Sue Green, RN
• Wyatt Thomas Greene
• Jeremy Keith Greenwood, LICSW
• Tanja Gribble, L.M.P.

• Community/Behavioral Health Agency in Centralia, WA
• Providers in Centralia, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.