NPIMap

Organization Active NPI

Kitsap County Juvenile Department

  • Children's Substance Abuse Rehabilitation Facility
  • Port Orchard, WA
National Provider Identifier
1679765226
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X
License
18006700 Issued in WA
Legal business name
KITSAP COUNTY JUVENILE DEPARTMENT
Practice address
1338 SW Old Clifton Rd
Port Orchard, WA 98367-9113
Phone
(360) 337-5401
Fax
(360) 337-5404
NPI assigned
Aug 16, 2007
Organization subpart
Yes
Parent organization
KITSAP COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Authorized official

Name
Ms. Nancy J Wilson
Title
Administrative Services Manager
Phone
(360) 337-5401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Substance Abuse Rehabilitation Facility 3245S0500X 18006700 WA Primary

Addresses

Primary practice location

1338 SW Old Clifton Rd
Port Orchard, WA 98367-9113

Mailing address

1338 SW Old Clifton Rd
Port Orchard, WA 98367-9113
Phone (360) 337-5401

Other names 1

  • Kitsap Adolescent Recovery Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Kitsap Co Fire Dist 14 organizations share this tax ID, including this one
Part of
Kitsap Co Fire Dist 1

Other organizations with this tax ID 3

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

Locations

1338 SW Old Clifton Rd
Port Orchard, WA 98367
Phone (360) 337-5401

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1679765226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 SW OLD CLIFTON RD",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983679113",
            "telephone_number": "360-337-5401",
            "fax_number": "360-337-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 SW OLD CLIFTON RD",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983679113",
            "telephone_number": "360-337-5401",
            "fax_number": "360-337-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP COUNTY JUVENILE DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KITSAP COUNTY",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES MANAGER",
        "authorized_official_telephone_number": "360-337-5401",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "WA",
            "license": "18006700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kitsap Adolescent Recovery Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.