Illahee Home Corp

NPI #1265982763 in Bellingham, Washington

Provider Information

NPI Number: 1265982763
Entity Type: Organization
Organization Name: Illahee Home Corp
Subpart: Yes (part of a larger organization)
Parent Organization: ILLAHEE HOME CORP
Primary Specialty: Counselor
Enumeration Date: Oct 7, 2016
Last Updated: Jan 7, 2025

Practice Location

Address: 1130 N STATE ST
City: Bellingham
State: Washington
ZIP Code: 98225-5014
Phone: (360) 676-4485

Authorized Official

Name: MR. KELLY RYAN FROST, CDP
Title: COUNSELOR
Phone: (360) 676-4485

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X
Psychiatry & Neurology - Addiction Medicine — Addiction Medicine	2084A0401X
Psychiatry & Neurology - Addiction Psychiatry — Addiction Psychiatry	2084P0802X
Community/Behavioral Health	251S00000X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Counselor	101Y00000X	Primary

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