Provider Demographics
NPI:1073325759
Name:CENTRO LATINO NW FAMILY SERVICE INSTITUTE-CORP
Entity type:Organization
Organization Name:CENTRO LATINO NW FAMILY SERVICE INSTITUTE-CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHACON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:509-667-1926
Mailing Address - Street 1:768 S MISSION ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3052
Mailing Address - Country:US
Mailing Address - Phone:509-667-1926
Mailing Address - Fax:
Practice Address - Street 1:768 S MISSION ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3052
Practice Address - Country:US
Practice Address - Phone:509-667-1926
Practice Address - Fax:509-888-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251300000XAgenciesLocal Education Agency (LEA)
No251S00000XAgenciesCommunity/Behavioral Health