| NPI | 1114635133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI RENEE HAMILTON Owner 360-888-4577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-11-08 |
| Last Update Date | 2022-11-08 |