NPIMap

Organization Active NPI

Sequoia Detox Centers LLC

  • Substance Abuse Rehabilitation Facility
  • Spokane Valley, WA
National Provider Identifier
1487289567
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
SEQUOIA DETOX CENTERS LLC
Practice address
10305 E Montgomery Dr
Spokane Valley, WA 99206-4220
Phone
(206) 605-2209
NPI assigned
Mar 9, 2020
Last updated
Oct 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Mrs. Audrey Grimm, ARNPNPI 1861188294
Title
Chief Executive Officer
Phone
(509) 873-4066

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

10305 E Montgomery Dr
Spokane Valley, WA 99206-4220

Mailing address

10305 E Montgomery Dr
Spokane Valley, WA 99206-4220
Phone (509) 418-2108

Other practice location 1

421 N Mullan Rd
Spokane Valley, WA 99206-2405
Phone (509) 934-1087

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2262445Sequoia Detox Centers10305 E Montgomery Dr, Spokane, WA 99206Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

10305 E Montgomery Dr
Spokane Valley, WA 99206
Phone (206) 605-2209

421 N Mullan Rd
Spokane Valley, WA 99206
Phone (509) 934-1087

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1487289567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10305 E MONTGOMERY DR",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064220",
            "telephone_number": "509-418-2108",
            "fax_number": "509-315-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10305 E MONTGOMERY DR",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064220",
            "telephone_number": "206-605-2209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "421 N Mullan Rd",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992062405",
            "country_code": "US",
            "telephone_number": "509-934-1087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SEQUOIA DETOX CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-09",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "GRIMM",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "509-873-4066",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.