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Organization

NORTHWEST INDIAN TREATMENT CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JUNE O'BRIEN (DIRECTOR)
(360) 470-1474
Entity
Organization

Contact information

Practice address
308 E. YOUNG STREET, BOX 477, ELMA, WA 98541
(360) 482-2674
Mailing address
308 EAST YOUNG STREET, BOX 477, ELMA, WA 98541-0000

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
RTF1034
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1981026
WA
05
1990696
WA
Enumeration date
10/20/2006
Last updated
08/22/2020
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