Abstemious Outpatient Clinic, Inc

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

CP0001358 Issued in 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

Last updated

Oct 23, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

ABSTEMIOUS OUTPATIENT CLINIC, INCAs reported in NPPES

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

Authorized official

Name

Ronald J Phelps, B.A., C.D.P.

Title

Executive Director Abstemious Outpa

Phone

(509) 927-7814

Specialties & licenses 2

Addresses

Other names 1

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

Part of

Abstemious Outpatient C

Locations

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1740328145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10525 E. MAIN AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992063728",
            "telephone_number": "509-927-7814",
            "fax_number": "509-927-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10525 E MAIN AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992063728",
            "telephone_number": "509-927-7814",
            "fax_number": "509-927-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABSTEMIOUS OUTPATIENT CLINIC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ABSTEMIOUS OUTPATIENT CLINIC, INC",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR ABSTEMIOUS OUTPA",
        "authorized_official_telephone_number": "509-927-7814",
        "authorized_official_credential": "B.A., C.D.P."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "32051201",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "CP0001358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ronald J. Phelps, B.A., CDP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.