Organization
COLONIAL CLINIC III, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS H. STOLZ HUSTON STOLZ CDP (CLINIC DIRECTOR/COUNSELOR)
(509) 327-9831
Entity
Organization
Contact information
Practice address
910 N WASHINGTON ST STE 210, SPOKANE, WA 99201-2260
(509) 327-9831
(509) 327-9857
Mailing address
910 N WASHINGTON ST STE 210, SPOKANE, WA 99201-2260
(509) 327-9831
(509) 327-9857
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
32025500
WA
252Y00000X
Early Intervention Provider Agency
Primary
32025500
WA
Other
Enumeration date
02/22/2013
Last updated
02/22/2013
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