Organization
LILAC CITY BEHAVIORAL SERVICES, PLLC
Active
Organization
LILAC CITY BEHAVIORAL SERVICES, PLLC
Active
Other names
Lilac City Behavioral
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY STAN KALLES M.S., BCBA (CEO/MEMBER)
(509) 844-4966
Entity
Organization
Contact information
Practice address
318 E ROWAN AVE STE 201, SPOKANE, WA 99207-1200
(509) 844-2429
(509) 319-2338
Mailing address
318 E ROWAN AVE STE 201, SPOKANE, WA 99207-1200
(509) 844-2429
(509) 319-2338
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2080619
—
WA
Enumeration date
10/17/2016
Last updated
07/21/2020
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