| NPI | 1588002216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE WILSON Billing Manager 509-209-2777 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2016-02-01 |