Provider Demographics
NPI:1013030147
Name:SPOKANE ADDICTION RECOVERY CENTERS
Entity Type:Organization
Organization Name:SPOKANE ADDICTION RECOVERY CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWNLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-624-3251
Mailing Address - Street 1:PO BOX 20159
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-7159
Mailing Address - Country:US
Mailing Address - Phone:509-624-3251
Mailing Address - Fax:509-624-4505
Practice Address - Street 1:812 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-3326
Practice Address - Country:US
Practice Address - Phone:509-624-3251
Practice Address - Fax:509-624-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1991165Medicaid