| NPI | 1205054053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE SIMPSON Supervisor 509-735-2704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 03 0546 00) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |