Organization
CHILDREN'S HOME SOCIETY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANA LILIA GONZALEZ (WISE COORDINATOR)
(509) 663-0034
Entity
Organization
Contact information
Practice address
1014 WALLA WALLA AVE, WENATCHEE, WA 98801-1523
(509) 663-0034
Mailing address
1014 WALLA WALLA AVE, WENATCHEE, WA 98801-1523
(509) 663-0034
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
CG60549819
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG60549819
COUNSELOR AGENCY AFFILIATED REGISTRATION
WA
Enumeration date
11/07/2017
Last updated
11/07/2017
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