| NPI | 1417299215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WILLIAM ALTIG President 360-694-0984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 60255260911) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-03-20 |