Provider Demographics
NPI:1043998008
Name:RAINIER RECOVERY CENTERS, LLC
Entity Type:Organization
Organization Name:RAINIER RECOVERY CENTERS, LLC
Other - Org Name:RAINIER RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:DUNLAP
Authorized Official - Suffix:SR
Authorized Official - Credentials:SUDP
Authorized Official - Phone:253-359-3219
Mailing Address - Street 1:4909 108TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-3724
Mailing Address - Country:US
Mailing Address - Phone:253-544-4772
Mailing Address - Fax:253-276-0042
Practice Address - Street 1:4909 108TH ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-3724
Practice Address - Country:US
Practice Address - Phone:253-544-4772
Practice Address - Fax:253-276-0042
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAINIER RECOVERY CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-10
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251B00000XAgenciesCase Management