Provider Demographics
NPI:1366747974
Name:AT PARR OUTPATIENT SERVICES, LLC
Entity type:Organization
Organization Name:AT PARR OUTPATIENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:PARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-325-0777
Mailing Address - Street 1:124 E AUGUSTA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-2481
Mailing Address - Country:US
Mailing Address - Phone:509-325-0777
Mailing Address - Fax:509-325-3464
Practice Address - Street 1:124 E AUGUSTA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2481
Practice Address - Country:US
Practice Address - Phone:509-325-0777
Practice Address - Fax:509-325-3464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA321298251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health