| NPI | 1508970799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE JOHNSTONE Owner/ Administrator 360-373-4077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2012-08-29 |