| NPI | 1437485679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANE VAN DER SLUIS President 360-695-8332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA PY00001784) |
| Enumeration Date | 2009-10-22 |
| Last Update Date | 2009-10-22 |