| NPI | 1275823536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE L THOMPSON CEO 360-628-1256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA 34 1527 00) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WA LH60174986) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WA LH60174986) | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2011-04-07 |