| NPI | 1073534228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS RUSSELL CEO 509-444-7033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: WA 011601) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WA 011601) |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2022-09-22 |