Provider Demographics
NPI:1811123631
Name:BENTON/FRANKLIN COUNTY CRISIS RESPONSE UNIT
Entity type:Organization
Organization Name:BENTON/FRANKLIN COUNTY CRISIS RESPONSE UNIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:CABLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS,DMHP,LMHC
Authorized Official - Phone:509-783-0500
Mailing Address - Street 1:2635 W DESCHUTES AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-3004
Mailing Address - Country:US
Mailing Address - Phone:509-783-0500
Mailing Address - Fax:509-783-9129
Practice Address - Street 1:2635 W DESCHUTES AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3004
Practice Address - Country:US
Practice Address - Phone:509-783-0500
Practice Address - Fax:509-783-9129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA020701RC00033141251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health