| NPI | 1356551717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MICHAEL DICKINSON Administrator 360-740-4380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2025-10-24 |