| NPI | 1154197614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKI J PEONE Clinic Administrator 509-514-6713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-11-27 |