| NPI | 1245545532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY MATHESON WEKELL Administrator 253-473-7586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA 27 1451 00) |
| Enumeration Date | 2010-08-11 |
| Last Update Date | 2010-08-11 |