Provider Demographics
NPI:1043332133
Name:THE VALLEY ALCOHOL COUNCIL
Entity Type:Organization
Organization Name:THE VALLEY ALCOHOL COUNCIL
Other - Org Name:MERIT RESOURCE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHEREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:SUDP
Authorized Official - Phone:509-837-7700
Mailing Address - Street 1:PO BOX 1039
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-1926
Mailing Address - Country:US
Mailing Address - Phone:509-925-9821
Mailing Address - Fax:509-963-3941
Practice Address - Street 1:200 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3347
Practice Address - Country:US
Practice Address - Phone:509-925-9821
Practice Address - Fax:509-925-9073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2022-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 261QM0801X
WA19 1740 00261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2055749Medicaid
WA1001133Medicaid
WABHA.FS.60873170OtherDOH LICENSE