Provider Demographics
NPI:1215765185
Name:TRI-COUNTY COMMUNITY HEALTH FUND
Entity type:Organization
Organization Name:TRI-COUNTY COMMUNITY HEALTH FUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BACON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-684-7925
Mailing Address - Street 1:528 S WYNNE ST
Mailing Address - Street 2:
Mailing Address - City:COLVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99114-2518
Mailing Address - Country:US
Mailing Address - Phone:509-684-7925
Mailing Address - Fax:
Practice Address - Street 1:282 W ASTOR AVE
Practice Address - Street 2:
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114-2418
Practice Address - Country:US
Practice Address - Phone:509-684-7925
Practice Address - Fax:509-563-8200
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE STREET PROJECT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility