NPIMap

Organization Active NPI

Department of Social and Health Service

  • Mental Illness Community Based Residential Treatment Facility
  • Centralia, WA
National Provider Identifier
1073370045
Registry record updated Mar 5, 2024
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 SERVICE
Practice address
20311 Old Highway 9 SW
Centralia, WA 98531
Phone
(564) 464-5439
NPI assigned
Mar 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Amy Umberger, LICSW
Title
Ngri Quality Manager
Phone
(253) 993-0557

Specialties & licenses 1

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

Addresses

Primary practice location

20311 Old Highway 9 SW
Centralia, WA 98531

Mailing address

20311 Old Highway 9 SW
Centralia, WA 98531

Other names 1

  • DSHS Behavioral and Treatment Center-Maple Lane Doing business as

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

NPI Registry JSON

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1073370045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20311 OLD HIGHWAY 9 SW",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20311 OLD HIGHWAY 9 SW",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "564-464-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF SOCIAL AND HEALTH SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "UMBERGER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "NGRI QUALITY MANAGER",
        "authorized_official_telephone_number": "253-993-0557",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DSHS Behavioral and Treatment Center-Maple Lane",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 5, 2024; 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.