Provider Demographics
NPI:1578864880
Name:CONSUMER VOICES ARE BORN
Entity Type:Organization
Organization Name:CONSUMER VOICES ARE BORN
Other - Org Name:VAL OGDEN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV
Authorized Official - Phone:360-397-8050
Mailing Address - Street 1:PO BOX 1707
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98668-1707
Mailing Address - Country:US
Mailing Address - Phone:360-397-8050
Mailing Address - Fax:360-397-8059
Practice Address - Street 1:1601 E 4TH PLAIN BLVD
Practice Address - Street 2:BLDG 17, STE A114
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3713
Practice Address - Country:US
Practice Address - Phone:360-397-8050
Practice Address - Fax:360-397-8059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA200133251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health