Provider Demographics
NPI:1629268560
Name:ASOTIN COUNTY COMMUNITY SERVICES
Entity Type:Organization
Organization Name:ASOTIN COUNTY COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MERVIN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:509-758-9842
Mailing Address - Street 1:549 5TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-1980
Mailing Address - Country:US
Mailing Address - Phone:509-758-9842
Mailing Address - Fax:
Practice Address - Street 1:549 5TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-1980
Practice Address - Country:US
Practice Address - Phone:509-758-9842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services