| NPI | 1629362108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN S NEISWENDER CFO 253-502-5403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA 34140400) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2011-06-02 |