| NPI | 1104267558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER GOODWIN President/Program Director 360-352-3034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 34139400) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2013-07-15 |