| NPI | 1659171635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYNN MATHIS Managed Member 509-435-6699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-03-18 |
| Last Update Date | 2025-03-18 |