OrganizationActive
Department of Social and Health Services
NPI 1043933617 · Mental Illness Community Based Residential Treatment Facility · Centralia, WA
Provider details
- NPI number
- 1043933617
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Melissa Tengowski, Qaim(360) 999-3851
Specialties & taxonomies
Residential Treatment Facilities
Practice location
20413 Old Hwy 9 Sw
Centralia, WA 98531
Phone: (360) 999-7678
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 45861
Olympia, WA 98504-5861
Registry dates
- Enumerated
- 2022-09-20
- Last updated
- 2022-09-20
- Certified
- 2022-09-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.