| NPI | 1407080187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANDON EUGENE POPPLETON Director 360-261-3355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 60041144) |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2009-05-08 |