| NPI | 1003499195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAITLYN GOUBEAU CEO 360-367-4284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2025-03-17 |