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Organization
CLALLAM COUNTY JUVENILE AND FAMILY SERVICES
Active
Organization
CLALLAM COUNTY JUVENILE AND FAMILY SERVICES
Active
Other names
TRUE STAR RECOVERY PROGRAM
Organization subpart
No
Provider details
NPI number
Authorized official
PETE PETERSON (ADMINISTRATOR)
(360) 565-2628
Entity
Organization
Contact information
Practice address
1912 W 18TH ST, PORT ANGELES, WA 98363-5121
(360) 565-2621
(360) 457-4875
Mailing address
1912 W 18TH ST, PORT ANGELES, WA 98363-5121
(360) 565-2621
(360) 457-4875
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8022592
—
WA
01
—
91136
PSE HEALTHTRUST
WA
Enumeration date
09/27/2006
Last updated
08/22/2020
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