| NPI | 1073864849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JEFFREY WOODARD Executive Director 360-280-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA CL60302030) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-09-20 |