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EXCELSIOR YOUTH CENTER

Ambulatory Health Care Facilities Clinic/Center Adolescent and Children Mental Health

Provider NPI: 1326267055

Organization Information:
Organization Name:  EXCELSIOR YOUTH CENTER
Organization is not Subpart
Authorized Official:  ANDREW R HILL  CEO/PRESIDENT  509-328-7041

Practice Location:
3754 W INDIAN TRAIL RD  SPOKANE, WA 99208-4736 US
Tel: 509-328-7041  Fax: 509-328-7582

Business Mailing Address:
3754 W INDIAN TRAIL RD  SPOKANE, WA 99208-4736 US
Tel: 509-328-7041  Fax: 509-328-7582

NPI Information:
NPI: 1326267055
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N261QM0855XAmbulatory Health Care Facilities
Clinic/Center
Adolescent and Children Mental Health
WA32 0893 00 / 181
N261QR0405XAmbulatory Health Care Facilities
Clinic/Center
WA32 0893 00 / 181
N320800000XResidential Treatment Facilities
Community Based Residential Treatment Facility, Mental Illness
WA32 0893 00 / 181
N322D00000XResidential Treatment Facilities
Residential Treatment Facility, Emotionally Disturbed Children
WA32 0893 00 / 181
N323P00000XResidential Treatment Facilities
Psychiatric Residential Treatment Facility
WA32 0893 00 / 181
N3245S0500XResidential Treatment Facilities
Substance Abuse Rehabilitation Facility
WA32 0893 00 / 181
N251B00000XAgencies
Case Management
WA32 0893 00 / 181
N251C00000XAgencies
Day Training, Developmentally Disabled Services
WA32 0893 00 / 181
Y261QM0801XAmbulatory Health Care Facilities
Clinic/Center
WA32 0893 00 / 181

Other Provider Identifiers:

IssuerNumberStateType
450639WA05
1993435WA05
1007885WA05
2015145WA05



American Medical Association 2012 taxonomy code information

Code: 261QM0801X

Type:

Classification:



Definition:



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