| NPI | 1073995080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE LAGER Office Director 360-515-0422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WA RTF.FS.60577277) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2015-06-25 |