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Organization

SQUAXIN ISLAND TRIBE

Active
Parent organization
SQUAXIN ISLAND TRIBE
Other names
Mental Health Skillbuilders
Organization subpart
Yes

Provider details

NPI number
Legal business name
SQUAXIN ISLAND TRIBE
Authorized official
EDWARD J FOX PHD (HHS DIRECTOR)
(360) 427-9006
Entity
Organization

Contact information

Practice address
90 SE KLAH CHE MIN DRIVE, SHELTON, WA 98584
(360) 427-9006
(360) 427-1951
Mailing address
90 SE KLAH CHE MIN DRIVE, SHELTON, WA 98584
(360) 427-9006
(360) 427-1951

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
600371470
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1980994
WA
Enumeration date
05/18/2007
Last updated
07/25/2008
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