| NPI | 1225282627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MYRICK Administrator 253-922-6522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00005499) |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2008-11-11 |