| NPI | 1326546235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIS GRANT THOMPSON Executive Director 360-718-8376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 604176297) |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2025-03-11 |