NPIMap

Organization Active NPI

Eugenia Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Mossyrock, WA
National Provider Identifier
1508426875
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
EUGENIA CENTER
Practice address
230 E State St
Mossyrock, WA 98564-2501
Phone
(360) 983-3227
NPI assigned
Jun 18, 2019
Last updated
Mar 9, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
EUGENIA CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Authorized official

Name
Fabiola Gonzalez
Title
Executive Director
Phone
(360) 266-5585

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

230 E State St
Mossyrock, WA 98564-2501

Mailing address

PO Box 1371
Chehalis, WA 98532-0340
Phone (360) 948-0203

Other identifiers 1

IdentifierTypeStateIssuer
1009072MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Eugenia Center4 organizations share this tax ID, including this one
Part of
Eugenia Center

Other organizations with this tax ID 3

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

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": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583712000000",
    "number": "1508426875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1371",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985320340",
            "telephone_number": "360-948-0203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E STATE ST",
            "city": "MOSSYROCK",
            "state": "WA",
            "postal_code": "985642501",
            "telephone_number": "360-983-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENIA CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EUGENIA CENTER",
        "enumeration_date": "2019-06-18",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "FABIOLA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-266-5585"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009072",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mossyrock, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; 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.