| NPI | 1508110370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY A SHIRLEY Admin. Assistant 509-865-5121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA CP 00001456) |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2012-11-01 |