| NPI | 1487024360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM WALDO Director Of Business Operations 253-312-8909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 603530320) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2015-10-05 |