Provider Demographics
NPI:1891171302
Name:HAYES-ELLINGWOOD COUNCILING SERVICES LLC
Entity Type:Organization
Organization Name:HAYES-ELLINGWOOD COUNCILING SERVICES LLC
Other - Org Name:THE CENTER FOR CHILDREN AND FAMILIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-483-1866
Mailing Address - Street 1:4407 N DIVISION ST
Mailing Address - Street 2:SUITE #304
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:509-483-1876
Practice Address - Street 1:4407 N DIVISION ST
Practice Address - Street 2:SUITE #304
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1600
Practice Address - Country:US
Practice Address - Phone:509-483-1866
Practice Address - Fax:509-483-1876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1376819441Medicaid