NPIMap

Organization Active NPI

Opioid & Alcohol Addiction Clinic

  • Community/Behavioral Health Agency
  • Lakewood, WA
National Provider Identifier
1548770704
Registry record updated Oct 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
OPIOID & ALCOHOL ADDICTION CLINIC
Practice address
4928 109TH St SW
Lakewood, WA 98499-3731
Phone
(253) 332-2958
NPI assigned
Oct 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2017

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

Authorized official

Name
Mrs. Bopha Kreuk
Title
Owner
Phone
(253) 632-6348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

4928 109TH St SW
Lakewood, WA 98499-3731

Mailing address

PO Box 6015
Federal Way, WA 98063-6015
Phone (253) 332-2958

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506902400000",
    "number": "1548770704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6015",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980636015",
            "telephone_number": "253-332-2958",
            "fax_number": "253-838-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4928 109TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993731",
            "telephone_number": "253-332-2958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPIOID & ALCOHOL ADDICTION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A",
        "authorized_official_last_name": "KREUK",
        "authorized_official_first_name": "BOPHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-632-6348",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.