Abstemious Outpatient Clinic, Inc

Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Spokane Valley, WA

NPI 1740328145 · NPPES record last updated Oct 23, 2012

Key facts

NPI
1740328145
Entity type
Organization (NPI type 2)
Primary specialty
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
License
CP0001358 (WA)
Legal business name
ABSTEMIOUS OUTPATIENT CLINIC, INC
Practice address
10525 E Main Ave
Spokane Valley, WA 99206-3728
Phone
(509) 927-7814
Fax
(509) 927-4669
NPI assigned
Feb 1, 2007
Organization subpart
Yes
Parent organization (as reported)
ABSTEMIOUS OUTPATIENT CLINIC, INC

Authorized official

Name
Ronald J Phelps, B.A., C.D.P.
Title
Executive Director Abstemious Outpa
Phone
(509) 927-7814

National Provider Directory

Part of
Abstemious Outpatient Clinic Inc

Locations

10525 E Main Ave
Spokane Valley, WA 99206
Phone (509) 217-5326

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 32051201 WA
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X CP0001358 WA Yes

Addresses

Primary practice location

10525 E Main Ave
Spokane Valley, WA 99206-3728

Mailing address

10525 E. Main Ave
Spokane Valley, WA 99206-3728
Phone (509) 927-7814

Other identifiers

IdentifierTypeStateIssuer
32051200OtherWADSHS
32051200OtherWADASA
32051201OtherWADASA
32051200/32051201OtherWADSHS/DBHR
32051201OtherWADSHS

Other names

  • Ronald J. Phelps, B.A., CDP Other name

Other providers in Spokane Valley, WA

All providers in Spokane Valley, WA · Substance Use Disorder Rehabilitation Clinic/Center in Washington

Sources for this page

Verify at the official NPI Registry.