| NPI | 1023301447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTNY MATTHEWS Office Manager 125-393-9243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 603106060) |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |