NPIMap

Organization Active NPI

Kitsap County

  • Substance Abuse Rehabilitation Facility
  • Bremerton, WA
National Provider Identifier
1801003439
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
18006700 Issued in WA
Legal business name
KITSAP COUNTY
Practice address
1975 NE Fuson Rd
Bremerton, WA 98311-3738
Phone
(360) 337-4625
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Ms. Lisa C Romwall, MA
Title
Director
Phone
(360) 337-4625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 18006700 WA Primary

Addresses

Primary practice location

1975 NE Fuson Rd
Bremerton, WA 98311-3738

Mailing address

1975 NE Fuson Rd
Bremerton, WA 98311-3738
Phone (360) 337-4625

Other identifiers 1

IdentifierTypeStateIssuer
1991090MedicaidWA

Other names 1

  • Kitsap Recovery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kitsap Co Fire Dist 14 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

1975 NE Fuson Rd
Bremerton, WA 98311
Phone (360) 337-4625

661 Taylor St
Port Orchard, WA 98366
Phone (360) 337-4625

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1801003439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 NE FUSON RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983113738",
            "telephone_number": "360-337-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 NE FUSON RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983113738",
            "telephone_number": "360-337-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "ROMWALL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "360-337-4625",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "WA",
            "license": "18006700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1991090",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kitsap Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.