| NPI | 1023167152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNY RAY REYNOLDS Clinical Supervisor 425-742-6410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WA 310300ALCHOL DRUG) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2020-08-22 |