| NPI | 1619680998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA CROSS Owner 509-879-8560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2023-01-02 |
| Last Update Date | 2025-06-02 |