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COMMUNITY INTEGRATED HEALTH SERVICES, LLC

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Company Details

Legal Name: COMMUNITY INTEGRATED HEALTH SERVICES, LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: September 15th 2019
Expiration date: 30 Sep 2025
UBI Number: 604 473 830
ZIP code: 98532
City: Chehalis
County: LEWIS
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1861 S MARKET BLVD, CHEHALIS, WA, 98532-4136, UNITED STATES
Principal Office Mailing Address: Google Maps Logo PO BOX 1447, CHEHALIS, WA, 98532, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $849,652

Contact Details

E-Mail: KBLUHM@GREATRIVERSBHO.ORG
Phone Number: +1 360-795-5942

Nature of Business

Health Care, Social Assistance & Service Organization, BEHAVIORAL HEALTH SERVICES INCLUDING MENTAL HEALTH SERVICES AND SUBSTANCE USE DISORDER SERVICES

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Registered Agent Information

Name Role Address
MARC BOLLINGER Registered Agent 1861 S MARKET BLVD, CHEHALIS, WA, 98532-4136, UNITED STATES

Key Officers & Management

Name Role Address
BRIAN CAMERON Executor 57 W MAIN ST, SUITE 260, CHEHALIS, WA, 98532-4815, UNITED STATES
SHAWN ANDREWS, MD Governing Person -
PAUL SCHNEIDER, MD Governing Person -
MICHAEL BARTLETT, MD Governing Person -

Unique Entity ID

Unique Entity ID:
WHPFWPKTRLF5
CAGE Code:
8TGY2
UEI Expiration Date:
2026-06-03

Business Information

Doing Business As:
COMMUNITY INTEGRATED HEALTH SERVICES LLC
Division Name:
COMMUNITY INTEGRATED HEALTH SERVICES, LLC
Activation Date:
2025-06-05
Initial Registration Date:
2020-12-14

National Provider Identifier

NPI Number:
1942840160
Certification Date:
2022-09-27

Authorized Person:

Name:
MR. MARC EDMUND BOLLINGER
Role:
EXECUTIVE DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
101YA0400X - Addiction (Substance Use Disorder) Counselor
Is Primary:
No
Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
No
Selected Taxonomy:
104100000X - Social Worker
Is Primary:
No
Selected Taxonomy:
163W00000X - Registered Nurse
Is Primary:
No
Selected Taxonomy:
175T00000X - Peer Specialist
Is Primary:
No
Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

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