| NPI | 1053861955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA DZIVAKWE Owner 206-329-5255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA PY 60666097) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2022-07-21 |