Provider Demographics
NPI:1780069583
Name:SOCIAL TREATMENT OPPORTUNITY PROGRAMS II, INC.
Entity type:Organization
Organization Name:SOCIAL TREATMENT OPPORTUNITY PROGRAMS II, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:TATUM
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:253-471-0890
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-0547
Mailing Address - Country:US
Mailing Address - Phone:509-855-9494
Mailing Address - Fax:509-765-4132
Practice Address - Street 1:104 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-1902
Practice Address - Country:US
Practice Address - Phone:509-855-9494
Practice Address - Fax:509-765-4132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No251B00000XAgenciesCase Management
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder