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Organization

A NEW SPIRIT RECOVERY PROGRAM INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD D COX NCACII CCDCII CDD (PRESIDENT CLINICAL DIRECTOR)
(425) 771-1194
Entity
Organization

Contact information

Practice address
22617 76TH AVE W, SUITE 101, EDMONDS, WA 98026
(425) 771-1194
(425) 771-4544
Mailing address
22617 76TH AVE W, SUITE 101, EDMONDS, WA 98026
(425) 771-1194
(425) 771-4544

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
31011000
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
321001
VALUEOPTIONS
01
477000
PREMERA BLUE CROSS
WA
01
NO-0620
REGENCE BLUE SHIELD
WA
Enumeration date
01/22/2007
Last updated
08/22/2020
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