NPI | 1538412630 |
---|---|
Other Name | COWLITZ TRIBAL TREATMENT |
Entity Type | Organization |
Authorized Contact | SHAVON KELLER Billing Supervisor 360-353-9431 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
Enumeration Date | 2012-10-26 |
Last Update Date | 2023-02-03 |