Organization
OPIOID & ALCOHOL ADDICTION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BOPHA KREUK (OWNER)
(253) 632-6348
Entity
Organization
Contact information
Practice address
4928 109TH ST SW, LAKEWOOD, WA 98499-3731
(253) 332-2958
Mailing address
PO BOX 6015, FEDERAL WAY, WA 98063-6015
(253) 332-2958
(253) 838-4145
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/02/2017
Last updated
10/02/2017
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