| NPI | 1164649679 |
|---|---|
| Other Name | COWLITZ TRIBAL TREATMENT |
| Entity Type | Organization |
| Authorized Contact | SHAVON KELLER Billing Supervisor 360-353-9431 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2024-07-22 |