| NPI | 1487884441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT W LONG Provider/Owner 253-862-7374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP0002606) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2013-02-28 |