Provider Demographics
NPI:1740731256
Name:MERIT RESOURCE SERVICES
Entity type:Organization
Organization Name:MERIT RESOURCE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEMICAL DEPENDENCY PROFESSIONAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENAY
Authorized Official - Middle Name:ANTOINETTE
Authorized Official - Last Name:BLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:CDP
Authorized Official - Phone:509-469-9366
Mailing Address - Street 1:315 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-2334
Mailing Address - Country:US
Mailing Address - Phone:509-469-9366
Mailing Address - Fax:509-469-9926
Practice Address - Street 1:315 N 2ND ST
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2334
Practice Address - Country:US
Practice Address - Phone:509-469-9366
Practice Address - Fax:509-469-9926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00003747101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty