WALLA WALLA COUNTY (WALLA WALLA COUNTY DEPARTMENT OF HUMAN SERVICES) - NPI NUMBER 1972687374

Summary

Provider Name: WALLA WALLA COUNTY (WALLA WALLA COUNTY DEPARTMENT OF HUMAN SERVICES)

NPI Number: 1972687374

Clasification: Community/Behavioral Health (251S00000X)

Address:
1520 KELLEY PL
SUITE 220
WALLA WALLA, WA
ZIP 99362

Phone Number: (509) 524-2920



Detailed Information

WALLA WALLA COUNTY is a community/behavioral health in Walla Walla, WA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. The assigned NPI number for this provider is 1972687374 and is registered as an organization entity type.
The provider Is Doing Business As Walla Walla County Department Of Human Services.

The provider's business address is:

1520 KELLEY PL
SUITE 220
WALLA WALLA, WA
ZIP 99362-654
Phone: (509) 524-2920
Fax: (509) 524-2993

The provider's authorized official is Harvey R Crowder .
The authorized official title is Interim Director and has the following contact phone number (509) 524-2920.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 1/4/2013.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1508056847 COUNTY OF WALLA WALLA
Community/Behavioral Health
1609287820 CENTRAL WASHINGTON COMPREHENSIVE MENTAL HEALTH
Community/Behavioral Health
1083859722 TEAMING FOR SUCCESS
Community/Behavioral Health

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 251S00000X Community/Behavioral Health WA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 251B00000SX MEDICAID WA
2 8853859 MEDICARE PIN WA
3 251S00000X MEDICAID WA

NPI Record

No. Field Name Field Value
1 NPI 1972687374
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name WALLA WALLA COUNTY
5 Provider Other Organization Name WALLA WALLA COUNTY DEPARTMENT OF HUMAN SERVICES
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 1520 KELLEY PL
8 Provider Second Line Business Practice Location Address SUITE 220
9 Provider Business Practice Location Address City Name WALLA WALLA
10 Provider Business Practice Location Address State Name WA
11 Provider Business Practice Location Address Postal Code 993628654
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 5095242920
14 Provider Business Practice Location Address Fax Number 5095242993
15 Provider Enumeration Date 10/24/2006
16 Last Update Date 1/4/2013
17 Authorized Official Last Name CROWDER
18 Authorized Official First Name HARVEY
19 Authorized Official Middle Name R
20 Authorized Official Title or Position INTERIM DIRECTOR
21 Authorized Official Telephone Number 5095242920
22 Healthcare Provider Taxonomy Code 1 251S00000X
23 Provider License Number State Code 1 WA
24 Healthcare Provider Primary Taxonomy Switch 1 Y
25 Other Provider Identifier 1 251B00000SX
26 Other Provider Identifier Type Code 1 05
27 Other Provider Identifier State 1 WA
28 Other Provider Identifier 2 8853859
29 Other Provider Identifier Type Code 2 08
30 Other Provider Identifier State 2 WA
31 Other Provider Identifier 3 251S00000X
32 Other Provider Identifier Type Code 3 05
33 Other Provider Identifier State 3 WA
34 Is Organization Subpart N
35 Authorized Official Name Prefix Text DR.
36 Authorized Official Credential Text DVM, MS, DACVPM

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.