| NPI | 1346508074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA K JECH Administrator 360-479-0853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 18022100) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |