| NPI | 1255030862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY VITACOLONNA Owner 360-349-8775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-03-03 |