| NPI | 1083917165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE WILSON Billing Manager 509-209-2777 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: ID 1SLSTAR002-1) |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: ID 4SLSTAR054) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2016-02-01 |