NPI | 1225300213 |
---|---|
Entity Type | Organization |
Authorized Contact | MICKEL L LEWIS Administrator/Program Director 360-665-4494 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WA RTF.FS.60221179) |
Enumeration Date | 2012-02-06 |
Last Update Date | 2012-02-06 |