Provider Demographics
NPI:1912663162
Name:SOLAKAI BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:SOLAKAI BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BOBBI
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LBA, BCBA, MSW
Authorized Official - Phone:808-922-5597
Mailing Address - Street 1:25852 243RD AVE SE
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-8473
Mailing Address - Country:US
Mailing Address - Phone:808-922-5597
Mailing Address - Fax:
Practice Address - Street 1:25852 243RD AVE SE
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-8473
Practice Address - Country:US
Practice Address - Phone:808-922-5597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty