Organization
ENTRUST COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM R GAULKE (CEO)
(509) 834-1220
Entity
Organization
Contact information
Practice address
213 S 11TH AVE, YAKIMA, WA 98902-3220
(509) 834-1220
Mailing address
PO BOX 9727, YAKIMA, WA 98909-0727
(509) 834-1220
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093418
—
WA
Enumeration date
01/04/2018
Last updated
01/04/2018
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