| NPI | 1205152949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA J JOHNS President 360-608-9311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA py60015408) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: OR 1936) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2024-11-04 |