| NPI | 1154031128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE CRUSE Owner 360-300-5755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2024-02-07 |