| NPI | 1467908855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY R MCCULLOUGH Director 425-328-9528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA 31-1480-00) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-27 |