| NPI | 1497266514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EDWARD CERKA Owner 206-693-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WA 60628193) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA 60628193) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2018-06-18 |