| NPI | 1568772655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAYNE STOOPS Owner 509-953-9961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ID LPC-4376) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: WA MC60115047) |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: ID LPC-4376) | |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2010-10-07 |