| NPI | 1003964545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE M. THELEN Compliance & Policy Analyst 253-761-3898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: WA 081) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: WA 081) |
| 261QM0850X Clinic/Center Adult Mental Health (Licence: WA 081) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: WA 081) | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: WA 17034300) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2018-06-07 |