A Change Into Recovery, LLC

Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Puyallup, WA

NPI 1073984480 · NPPES record last updated Oct 12, 2015

Key facts

NPI
1073984480
Entity type
Organization (NPI type 2)
Primary specialty
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Legal business name
A CHANGE INTO RECOVERY, LLC
Practice address
719 E Main Ave, Suite C
Puyallup, WA 98372
Phone
(253) 841-8165
Fax
(253) 841-8168
NPI assigned
Oct 12, 2015
Organization subpart
No

Authorized official

Name
Mr. Dave Harris, BA, CDP, NCAC II
Title
Administrator
Phone
(253) 841-8465

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Yes

Addresses

Primary practice location

719 E Main Ave, Suite C
Puyallup, WA 98372

Mailing address

719 E Main Ave, Suite C
Puyallup, WA 98372
Phone (253) 841-8165

Other providers in Puyallup, WA

All providers in Puyallup, WA · Substance Use Disorder Rehabilitation Clinic/Center in Washington

Sources for this page

Verify at the official NPI Registry.