| NPI | 1336527126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK JAMES CONNELL Director 360-696-4895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR C0662) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2015-05-12 |