Provider Demographics
NPI:1427837749
Name:ADVANCE HEALTH AND REHABILITATION
Entity type:Organization
Organization Name:ADVANCE HEALTH AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RIVER
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-535-4525
Mailing Address - Street 1:PO BOX 4245
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99220-0245
Mailing Address - Country:US
Mailing Address - Phone:360-839-9268
Mailing Address - Fax:509-255-3247
Practice Address - Street 1:731 S GARFIELD ST APT 9
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-5089
Practice Address - Country:US
Practice Address - Phone:509-535-4525
Practice Address - Fax:509-255-3247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty