| NPI | 1295191641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON C CASEY COO 206-399-0065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ OTC7455) |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2021-03-01 |