| NPI | 1316286958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO ORTIZ Director 509-313-6126 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 603255051) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |