Organization
TFD CARES/BEHAVIORAL HEALTH
Active
Parent organization
CITY OF TACOMA
Organization subpart
Yes
Provider details
NPI number
Legal business name
CITY OF TACOMA
Authorized official
SHANNON COLLAZO (LEAD CSR)
(253) 591-2044
Entity
Organization
Contact information
Practice address
901 FAWCETT AVE, TACOMA, WA 98402-5605
(253) 591-5737
(253) 591-5746
Mailing address
901 FAWCETT AVE, TACOMA, WA 98402-5605
(253) 591-5737
(253) 591-5737
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0056986
LABOR & INDUSTRIES
WA
01
—
590007108
UHC
WA
05
—
9032715
—
WA
05
—
G001002016
—
WA
Enumeration date
06/04/2021
Last updated
06/04/2021
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