| NPI | 1114354966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ANNE NEWTON President 360-487-0856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA MG60279602) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WA LH60507972) |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2016-04-29 |