Provider Demographics
NPI:1487218996
Name:BLUE MOUNTAIN ACTION COUNCIL
Entity Type:Organization
Organization Name:BLUE MOUNTAIN ACTION COUNCIL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY SERVICE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:JUANITA
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-301-4144
Mailing Address - Street 1:8 E CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-1946
Mailing Address - Country:US
Mailing Address - Phone:509-529-4980
Mailing Address - Fax:509-529-4985
Practice Address - Street 1:8 E CHERRY ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-1946
Practice Address - Country:US
Practice Address - Phone:509-529-4980
Practice Address - Fax:509-529-4985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management