| NPI | 1528628898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FABIOLA GONZALEZ Executive Director 360-266-5585 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2020-03-09 |