| NPI | 1356073514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAITY IMBS Owner 971-304-5285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-06-27 |