| NPI | 1548591779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYLAN ALAN BRASHEAR Administrator 360-393-4218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 37139900) |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2010-01-28 |