ABSTEMIOUS OUTPATIENT CLINIC, INC (NPI# 1740328145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740328145 |
| Entity Type | Organization |
| Organization Name | ABSTEMIOUS OUTPATIENT CLINIC, INC |
| Other Organization Name | RONALD J. PHELPS, B.A., CDP |
| Practice Address |
10525 E Main Ave Spokane Valley WA 99206-3728 |
| Mailing Address |
10525 E. Main Ave Spokane Valley WA 99206-3728 |
| Practice Telephone | 5099277814 |
| Practice Fax Number | 5099274669 |
| Mailing Telephone | 5099277814 |
| Mailing Fax Number | 5099274669 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2012-10-23 |
| Authorized Official Name | RONALD J PHELPS (EXECUTIVE DIRECTOR ABSTEMIOUS OUTPA) |
| Authorized Official Telephone | 5099277814 |
| Authorized Official Credential | B.A., C.D.P. |
| Is Organization Subpart | Y |
| Parent Organization Name | ABSTEMIOUS OUTPATIENT CLINIC, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
32051201 | WA | Ambulatory Health Care Facilities |
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
CP0001358 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | DSHS/DBHR | 32051200/32051201 | 01 |
| WA | DSHS | 32051200 | 01 |
| WA | DASA | 32051200 | 01 |
| WA | DSHS | 32051201 | 01 |
| WA | DASA | 32051201 | 01 |
| Other Name | Type Code |
|---|---|
| Ronald J. Phelps, B.A., CDP | Other Name - Individual/Organization |
| Street Address |
10525 E MAIN AVE |
| City | SPOKANE VALLEY |
| State | WA |
| Zip Code | 99206-3728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851913495 | Ea Healing Arts LLC | Acupuncturist | 210 N University Rd, Ste 200, Spokane Valley, WA 99206 | 2020-05-16 |
| 1922659630 | Creative Harmony Counseling LLC | Counselor | 721 N Pines Road, Spokane, WA 99206 | 2019-09-24 |
| 1477027092 | Hunter Badgley | Counselor | 721 N Pines Rd Ste 2, Spokane Valley, WA 99206 | 2019-01-16 |
| 1851880934 | Ryan Bushman | Dentist | 919 N Pines Rd, Spokane Valley, WA 99206 | 2018-05-04 |
| 1902307531 | Lois Jensen | Counselor | 3507 S. Spotted Rd., Spokane, WA 99206 | 2018-02-28 |
| 1295258804 | Melissa Ann Reamer | Speech-Language Pathologist | 2510 N. Pines Rd., Ste. 3, Spokane Valley, WA 99206 | 2017-07-25 |
| 1730619149 | Amanda Kathryn Fuchs | Counselor | 200 N Mullan Rd Ste 219, Spokane Valley, WA 99206 | 2017-06-18 |
| 1588105308 | Pine Ridge Management Wa LLC | Assisted Living Facility | 5615 West Umatilla, Spokane, WA 99206 | 2017-03-13 |
| 1427405893 | Sarah Winn | Counselor | 721 N Pines, Spokane Valley, WA 99206 | 2016-05-16 |
| 1134573199 | Elzbieta H Anderson | Acupuncturist | 210 N University Rd Ste 200, Spokane Valley, WA 99206 | 2016-04-15 |
| Find all providers in zip 99206 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1780174441 | American Behavioral Health Systems, Inc. | Clinic/Center | 715 E Sprague Ave Ste 107, Spokane, WA 99202-2142 | 2018-05-17 |
| 1598255267 | American Behavioral Healt Systems, Inc. | Clinic/Center | 7208 267th St Nw Ste A-100, Stanwood, WA 98292-6289 | 2018-05-17 |
| 1437648136 | American Behavioral Health Systems, Inc. | Clinic/Center | 8625 Evergreen Way Ste 100, Everett, WA 98208-2620 | 2018-05-08 |
| 1487143350 | Steve Parker | Clinic/Center | 1206 State Ave Ste H, Marysville, WA 98270-3645 | 2018-05-07 |
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| City | SPOKANE VALLEY |
| Zip Code | 99206 |
Please comment or provide details below to improve the information on ABSTEMIOUS OUTPATIENT CLINIC, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.