| NPI | 1255865135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA R TARVER Owner 425-429-4793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 11520651) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |