| NPI | 1144664210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT LEONARD MARQUIS Owner/Administrator 360-385-1258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA 16-1511-00) |
| Additional Taxonomies | 251B00000X Case Management (Licence: WA 16-1511-00) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2013-04-19 |