Organization
EXCELSIOR INTEGRATED CARE CENTER LLC
Active
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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