| NPI | 1467857904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY COONEY CEO 360-515-0070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA 34166800) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |