Provider Demographics
NPI:1801295126
Name:TRI CITIES RESIDENTIAL SERVIES
Entity type:Organization
Organization Name:TRI CITIES RESIDENTIAL SERVIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:J
Authorized Official - Last Name:LADOUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-783-3331
Mailing Address - Street 1:PO BOX 6084
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-0084
Mailing Address - Country:US
Mailing Address - Phone:509-783-3331
Mailing Address - Fax:509-783-3091
Practice Address - Street 1:741 S DAYTON ST
Practice Address - Street 2:SUITE A
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-5620
Practice Address - Country:US
Practice Address - Phone:509-783-3331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health