Organization
BRIGHTON DIVERSION SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROSS W KOLDITZ (PRESIDENT)
(360) 608-7399
Entity
Organization
Contact information
Practice address
97 MAPLE RIDGE RD, CATHLAMET, WA 98612-9648
(360) 608-7399
Mailing address
97 MAPLE RIDGE RD, CATHLAMET, WA 98612-9648
(360) 608-7399
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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