Provider Demographics
NPI:1639563232
Name:ANTIOCH COUNSELING AND TREATMENT SERVICES
Entity Type:Organization
Organization Name:ANTIOCH COUNSELING AND TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:RIGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-985-8770
Mailing Address - Street 1:12316 134TH CT NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-2433
Mailing Address - Country:US
Mailing Address - Phone:425-284-2652
Mailing Address - Fax:
Practice Address - Street 1:12316 134TH CT NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-2433
Practice Address - Country:US
Practice Address - Phone:425-284-2652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA17-1564-00261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder