Organization
GUARDIAN RECOVERY PROGRAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNDA J. WHITCOMB CDP (EXECUTIVE DIRECTOR)
(206) 545-0597
Entity
Organization
Contact information
Practice address
4812 AURORA AVE N, SEATTLE, WA 98103-6518
(206) 545-0597
Mailing address
4812 AURORA AVE N, SEATTLE, WA 98103-6518
(206) 545-0597
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
17046100
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
602518096
UBI
WA
Enumeration date
06/12/2008
Last updated
06/12/2008
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