| NPI | 1174677181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA S WIRTH Administrator 360-385-3866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 601 702 295) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2014-07-15 |