Organization
GRANT COUNTY PREVENTION AND RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER LANE (ADMINISTRATOR/COUNTY COORDINATOR)
(509) 765-5402
Entity
Organization
Contact information
Practice address
1525 E WHEELER RD, MOSES LAKE, WA 98837-9753
(509) 765-5402
(509) 766-2589
Mailing address
PO BOX 1217, MOSES LAKE, WA 98837-0185
(509) 765-5402
(509) 766-2589
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1990282
—
WA
Enumeration date
10/10/2006
Last updated
08/22/2020
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