NPIMap

Organization Active NPI

Modern Recovery, Inc.

Doing business as Virgil- Washington

  • Adult Mental Health Clinic/Center
  • Washington, WA
National Provider Identifier
1780342006
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MODERN RECOVERY, INC.
Doing business as
Virgil- Washington
Practice address
11335 Northeast 122ND Kirkland
Washington, WA 98034
Phone
(844) 991-0555
NPI assigned
Dec 3, 2021
Last updated
Dec 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Authorized official

Name
Andre Bahbah
Title
Director of RCM
Phone
(754) 270-6654

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Substance Abuse Rehabilitation Facility 324500000X NU

Addresses

Primary practice location

11335 Northeast 122ND Kirkland
Washington, WA 98034

Mailing address

11335 Northeast 122ND Kirkland
Washington, WA 98034

Other names 1

  • Virgil- Washington Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Modern Recovery Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

11335 NE 122nd Way
Kirkland, WA 98034
Phone (206) 895-4292

NPI Registry JSON

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1780342006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11335 NORTHEAST 122ND KIRKLAND",
            "city": "WASHINGTON",
            "state": "WA",
            "postal_code": "98034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11335 NORTHEAST 122ND KIRKLAND",
            "city": "WASHINGTON",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "844-991-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN RECOVERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "BAHBAH",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "754-270-6654"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virgil- Washington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Washington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.