Organization
GREATER LAKES MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEE JOHNSON RESOURCES (STAFF)
(253) 620-5014
Entity
Organization
Contact information
Practice address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
(253) 620-5014
(253) 620-5831
Mailing address
9330 59TH AVE SW, LAKEWOOD, WA 98499-2858
(253) 620-5014
(253) 620-5831
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
CG 60158344
WA
Other
Enumeration date
08/26/2010
Last updated
08/26/2010
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