| NPI | 1043933617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA TENGOWSKI Qaim 360-999-3851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2022-09-20 |