| NPI | 1447004072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL L.M. CRAWFORD CEO 360-200-8728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2024-04-11 |