| NPI | 1154049146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE S. WALTS-DONAHUE Operator 360-540-5104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2023-07-11 |