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OPIOID & ALCOHOL ADDICTION CLINIC

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Company Details

Legal Name: OPIOID & ALCOHOL ADDICTION CLINIC
Jurisdiction: WASHINGTON
Entity Type: WA NONPROFIT CORPORATION
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: September 25th 2017
Date of Dissolution: February 3rd 2019
Expiration date: 30 Sep 2018
UBI Number: 604 168 839
ZIP code: 98023
City: Federal Way
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1064 SW 325TH CT, FEDERAL WAY, WA, 98023, UNITED STATES

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Registered Agent Information

Name Role Address
DANIEL KIM Registered Agent 1064 SW 325TH CT, FEDERAL WAY, WA, 98023-4913, UNITED STATES

Key Officers & Management

Name Role
METREY KEO Governing Person
BOPHA KREUK Governing Person

National Provider Identifier

NPI Number:
1548770704

Authorized Person:

Name:
MRS. BOPHA KREUK
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Fax:
2538384145
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