| NPI | 1174812168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARDO CASTILLEJA Administrator 509-882-8012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA 39 1532 00) |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2011-03-30 |