Provider Demographics
NPI:1316248149
Name:CATHOLIC CHARITIES OF THE DIOCESE OF YAKIMA
Entity type:Organization
Organization Name:CATHOLIC CHARITIES OF THE DIOCESE OF YAKIMA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:DARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-965-7100
Mailing Address - Street 1:5301 TIETON DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3478
Mailing Address - Country:US
Mailing Address - Phone:509-965-7100
Mailing Address - Fax:509-972-0167
Practice Address - Street 1:5301 TIETON DR STE C
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3478
Practice Address - Country:US
Practice Address - Phone:509-965-7100
Practice Address - Fax:509-966-9750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1980028Medicaid