NPIMap

Organization Active NPI

Catholic Community Services Western Washington

Doing business as CCS RECOVERY CENTER-Snohomish

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Everett, WA
National Provider Identifier
1669645073
Registry record updated May 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
31085700 Issued in WA
Legal business name
CATHOLIC COMMUNITY SERVICES WESTERN WASHINGTON
Doing business as
CCS RECOVERY CENTER-Snohomish
Practice address
2610 Wetmore Ave
Everett, WA 98201-2927
Phone
(425) 258-5270
Fax
(425) 258-5275
NPI assigned
Apr 7, 2008
Last updated
May 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2014

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

Authorized official

Name
Ms. Donna M Wells, MA, CDPNPI 1649338088
Title
Director
Phone
(360) 676-2187

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 31085700 WA Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 31034400 WA

Addresses

Primary practice location

2610 Wetmore Ave
Everett, WA 98201-2927

Mailing address

515 Lakeway Dr
Bellingham, WA 98225-5233
Phone (360) 676-2187

Other identifiers 2

IdentifierTypeStateIssuer
1994771MedicaidWA
1990373MedicaidWA

Other names 1

  • CCS RECOVERY CENTER-Snohomish Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Catholic Community Services WW34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Locations

2610 Wetmore Ave
Everett, WA 98201
Phone (425) 258-5270

1227 2nd St
Marysville, WA 98270
Phone (360) 651-2366

Practitioners & affiliated clinicians

Practitioners 77

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.

View all 77

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400025600000",
    "number": "1669645073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 LAKEWAY DR",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982255233",
            "telephone_number": "360-676-2187",
            "fax_number": "360-676-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 WETMORE AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012927",
            "telephone_number": "425-258-5270",
            "fax_number": "425-258-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC COMMUNITY SERVICES WESTERN WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2014-05-14",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "360-676-2187",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, CDP"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "31085700",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "31034400",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1994771",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1990373",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCS RECOVERY CENTER-Snohomish",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; 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.