| NPI | 1609015437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE E BIGELOW Clinical Supervisor 360-332-8509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 37131800) |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2009-02-18 |