NPIMap

Organization Active NPI

Metropolitan Development Council

  • Mental Illness Community Based Residential Treatment Facility
  • Tacoma, WA
National Provider Identifier
1720470057
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
RTF.FS.60503763 Issued in WA
Legal business name
METROPOLITAN DEVELOPMENT COUNCIL
Practice address
721 Fawcett Ave Ste 100
Tacoma, WA 98402-5502
Phone
(253) 207-4302
NPI assigned
Feb 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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

Authorized official

Name
Mr. Mark Pereboom
Title
Persident and Ceo
Phone
(253) 591-0113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X RTF.FS.60503763 WA Primary

Addresses

Primary practice location

721 Fawcett Ave Ste 100
Tacoma, WA 98402-5502

Mailing address

945 Fawcett Ave
Tacoma, WA 98402-5612
Phone (253) 284-9049

National Provider Directory

National Provider Directory
Tax ID family
Metropolitan Development Council4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

721 Fawcett Ave
Ste 100
Tacoma, WA 98402
Phone (253) 250-1243

945 Fawcett Ave
Tacoma, WA 98402
Phone (253) 207-4301

Practitioners & affiliated clinicians

Practitioners 2

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": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1720470057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 FAWCETT AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025612",
            "telephone_number": "253-284-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025502",
            "telephone_number": "253-207-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN DEVELOPMENT COUNCIL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "PEREBOOM",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PERSIDENT AND CEO",
        "authorized_official_telephone_number": "253-591-0113",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "WA",
            "license": "RTF.FS.60503763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.