Provider Demographics
NPI:1184158750
Name:THE HEALING LODGE OF THE SEVEN NATIONS
Entity type:Organization
Organization Name:THE HEALING LODGE OF THE SEVEN NATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEMICAL DEPENDENCY PROFESSIONAL
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIN
Authorized Official - Middle Name:CHARLENE
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:CP00005216
Authorized Official - Phone:509-533-6910
Mailing Address - Street 1:5600 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-0220
Mailing Address - Country:US
Mailing Address - Phone:509-533-6910
Mailing Address - Fax:509-535-2863
Practice Address - Street 1:5600 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-0220
Practice Address - Country:US
Practice Address - Phone:509-533-6910
Practice Address - Fax:509-535-2863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children