Organization
GREAT RIVERS BEHAVIORAL HEALTH ORGANIZATION
Active
Organization
GREAT RIVERS BEHAVIORAL HEALTH ORGANIZATION
Active
Parent organization
GREAT RIVERS BEHAVIORAL HEALTH ORGANIZATI
Other names
Great Rivers Behavior Health Agency dba Community Integrated Health Services, Great Rivers Behavior Health Agency, Great Rivers Behavior Health Agency dba Community
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT RIVERS BEHAVIORAL HEALTH ORGANIZATI
Authorized official
MR. MARC EDMUND BOLLINGER LICSW (ADMINISTRATOR)
(360) 795-5955
Entity
Organization
Contact information
Practice address
57 W MAIN STREET, SUITE 260, CHEHALIS, WA 98532
(360) 795-5955
(360) 740-8099
Mailing address
PO BOX 1447, CHEHALIS, WA 98532
(360) 795-5955
(360) 740-8099
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
603564565
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200458
—
WA
Enumeration date
06/29/2017
Last updated
06/16/2018
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