| Asian American Chemical Dependency Treatment Services | |
|
9102 Bridgeport Way Sw Lakewood WA 98499-2418 | |
| (253) 302-3826 | |
| (253) 267-5212 |
| Full Name | Asian American Chemical Dependency Treatment Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 9102 Bridgeport Way Sw, Lakewood, Washington |
| Authorized Official Name and Position | Tae Son Lee (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2533023826 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Asian American Chemical Dependency Treatment Services 9100 Bridgeport Way Sw Lakewood WA 98499-2427 Ph: (253) 302-3826 | Asian American Chemical Dependency Treatment Services 9102 Bridgeport Way Sw Lakewood WA 98499-2418 Ph: (253) 302-3826 |
| NPI Number | 1144451048 |
|---|---|
| Provider Enumeration Date | 07/27/2009 |
| Last Update Date | 12/09/2024 |
| Certification Date | 12/09/2024 |
| Medicare PECOS PAC ID | 2062848104 |
|---|---|
| Medicare Enrollment ID | O20200207001351 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144451048 | NPI | - | NPPES |
| 2001629 | Medicaid | WA |
| Provider Name | Tae Son Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679904841 PECOS PAC ID: 6608202742 Enrollment ID: I20250114001384 |
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