| NPI | 1205017316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M DELOZIER Owner 509-469-5515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 39-1197-00) |
| Additional Taxonomies | 251B00000X Case Management (Licence: WA 39-1197-00) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2007-11-16 |