| Confederated Tribes Of The Colville Reservation | |
|
21 Colville Street Nespelem WA 99155-0150 | |
| (509) 634-2783 | |
| (509) 634-2781 |
| Full Name | Confederated Tribes Of The Colville Reservation |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 21 Colville Street, Nespelem, Washington |
| Authorized Official Name and Position | Amy Church (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 5096342783 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Confederated Tribes Of The Colville Reservation Po Box 150 Nespelem WA 99155-0150 Ph: (509) 634-2783 | Confederated Tribes Of The Colville Reservation 21 Colville Street Nespelem WA 99155-0150 Ph: (509) 634-2783 |
| NPI Number | 1609094838 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 08/23/2021 |
| Certification Date | 08/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609094838 | NPI | - | NPPES |
| 1980812 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1980812 (Washington) | Primary |
Colville Confederated Tribes Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Colville Street, Nespelem, WA 99155 Phone: 509-634-2433 Fax: 509-634-2781 |