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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32051200 | Other | WA | DSHS |
| 32051200 | Other | WA | DASA |
| 32051201 | Other | WA | DASA |
| 32051200/32051201 | Other | WA | DSHS/DBHR |
| 32051201 | Other | WA | DSHS |
Other names
- Ronald J. Phelps, B.A., CDP
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All providers in Spokane Valley, WA · Substance Use Disorder Rehabilitation Clinic/Center in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.