| NPI | 1376056796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA LILIA GONZALEZ Wi Se Coordinator 509-663-0034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WA CG60549819) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2017-11-07 |