| NPI | 1295180669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY MINNICK-BISHOP Owner 253-983-8507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA AP60594013) |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2016-05-04 |