Organization
EDUCATIONAL SERVICE DISTRICT 113
Active
Other names
True North Treatment
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT M VINCENT MA, CDP (ADMINISTRATOR)
(360) 790-2207
Entity
Organization
Contact information
Practice address
2100 N NATIONAL AVE, CHEHALIS, WA 98532-2301
(360) 748-2274
Mailing address
601 MCPHEE RD SW, OLYMPIA, WA 98502-5080
(360) 464-6874
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
21101800
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1993617
—
WA
Enumeration date
02/26/2007
Last updated
03/13/2008
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