| NPI | 1033538673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHIA REDD Billing Specialist 206-764-0502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 60265350) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2014-04-10 |