Organization
COMMUNITY INTEGRATED HEALTH SERVICES, LLC
Active
Parent organization
GREAT RIVERS BEHAVIORAL HEALTH ORGANIZATION, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREAT RIVERS BEHAVIORAL HEALTH ORGANIZATION, LLC
Authorized official
MR. MARC EDMUND BOLLINGER LICSW (EXECUTIVE DIRECTOR)
(360) 795-5955
Entity
Organization
Contact information
Practice address
1707 COOKS HILL RD, CENTRALIA, WA 98531-9071
(360) 261-6930
Mailing address
PO BOX 1447, CHEHALIS, WA 98532-0378
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
163W00000X
Registered Nurse
—
—
175T00000X
Peer Specialist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/15/2020
Last updated
09/27/2022
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