Basic Information
| Provider Information | |||||||||
| NPI: | 1083830285 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VOLUNTEERS OF AMERICA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2802 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982013642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256092210 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2802 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982013642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252593191 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 08/17/2009 | ||||||||
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| AuthorizedOfficialLastName: | MORRIS | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CCRS PROGRAM DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4252593191 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MED | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 084 | WA | Y | Agencies | Community/Behavioral Health |
No ID Information.