| NPI | 1306851175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS RUSSELL CEO 509-444-7033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: WA 200451) |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2022-09-22 |