| NPI | 1609920123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN R ERICKSON Executive Director 360-428-7835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA 600 308 646) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-09-26 |