| NPI | 1073839957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ROSALIA YORK Administrator, Executive Director 360-602-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 18148700) |
| Additional Taxonomies | 251S00000X (Licence: WA 18148700) |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2014-08-22 |