NPIMap

Organization Active NPI

Department of Social and Health Services

  • Mental Illness Community Based Residential Treatment Facility
  • Centralia, WA
National Provider Identifier
1043933617
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
Practice address
20413 Old Hwy 9 SW
Centralia, WA 98531
Phone
(360) 999-7678
NPI assigned
Sep 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Authorized official

Name
Melissa Tengowski
Title
Qaim
Phone
(360) 999-3851

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

20413 Old Hwy 9 SW
Centralia, WA 98531

Mailing address

PO Box 45861
Olympia, WA 98504-5861
Phone (360) 999-3851

National Provider Directory

National Provider Directory
Tax ID family
Lynden School District16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

20413 Old Highway 9 SW
Centralia, WA 98531
Phone (360) 999-7678

NPI Registry JSON

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1043933617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45861",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985045861",
            "telephone_number": "360-999-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20413 OLD HWY 9 SW",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "360-999-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF SOCIAL AND HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "TENGOWSKI",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "QAIM",
        "authorized_official_telephone_number": "360-999-3851"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.