Organization
ILLAHEE HOME CORP
Active
Parent organization
ILLAHEE HOME CORP
Other names
Belair Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ILLAHEE HOME CORP
Authorized official
MR. KELLY RYAN FROST CDP (COUNSELOR)
(360) 676-4485
Entity
Organization
Contact information
Practice address
1130 N STATE ST, BELLINGHAM, WA 98225-5014
(360) 676-4485
(360) 714-1294
Mailing address
1130 N STATE ST, BELLINGHAM, WA 98225-5014
(360) 676-4485
(360) 714-1294
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
CO60545681
WA
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
10/07/2016
Last updated
01/07/2025
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