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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