| NPI | 1457138760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ROZDILSKY Pharmacy Director 360-628-2109 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2023-09-11 |