Provider Demographics
NPI:1831479641
Name:KASSUHN INC
Entity Type:Organization
Organization Name:KASSUHN INC
Other - Org Name:ACTION COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:C
Authorized Official - Last Name:KASSUHN
Authorized Official - Suffix:
Authorized Official - Credentials:CDP
Authorized Official - Phone:360-895-1307
Mailing Address - Street 1:729 PROSPECT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-5330
Mailing Address - Country:US
Mailing Address - Phone:360-895-1307
Mailing Address - Fax:360-895-4805
Practice Address - Street 1:729 PROSPECT ST STE 200
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-5330
Practice Address - Country:US
Practice Address - Phone:360-895-1307
Practice Address - Fax:360-895-4805
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KASSUHN INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-24
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00004989324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility