| Great Rivers Behavioral Health Administrative Services Org | |
|
1723 Kresky Ave Centralia WA 98531 | |
| (800) 215-4460 | |
| (855) 936-1291 |
| Full Name | Great Rivers Behavioral Health Administrative Services Org |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1723 Kresky Ave, Centralia, Washington |
| Authorized Official Name and Position | Trinidad I Medina (CHIEF EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2533363237 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Rivers Behavioral Health Administrative Services Org Po Box 210 Chehalis WA 98532-0210 Ph: (800) 215-4460 | Great Rivers Behavioral Health Administrative Services Org 1723 Kresky Ave Centralia WA 98531 Ph: (800) 215-4460 |
| NPI Number | 1043861743 |
|---|---|
| Provider Enumeration Date | 09/24/2019 |
| Last Update Date | 03/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043861743 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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