| NPI | 1427935832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER PETROZZI Administrator 360-218-7970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2025-08-18 |
| Last Update Date | 2025-08-18 |