| NPI | 1396012530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN D COLLINS Administrator 360-452-4432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA CP00004528) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2011-11-16 |