| NPI | 1205360799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN LANE SMITH Mental Health Professional 360-415-5885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2017-04-12 |