Organization
EXCELSIOR INTEGRATED CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOVIE BRITTON (CONTRACTING AND CREDENTIALING COORD)
(509) 559-3132
Entity
Organization
Contact information
Practice address
3910 W. INDIAN TRAIL RD, SPOKANE, WA 99208-4739
(509) 559-3100
(509) 328-7582
Mailing address
3754 W INDIAN TRAIL RD, SPOKANE, WA 99208-4736
(509) 559-3100
(509) 328-7582
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
02/26/2020
Last updated
10/27/2020
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