| NPI | 1033662549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL OWUSU-AKYEAW Administrator 425-350-9818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: AZ BH4923) |
| Additional Taxonomies | 251S00000X |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2016-08-01 |
| Last Update Date | 2024-05-20 |