| NPI | 1659483113 |
|---|---|
| Doing Business As | PROVIDENCE ADOLESCENT RESIDENTIAL TREATMENT PROGRAM |
| Entity Type | Organization |
| Authorized Contact | DONALD W. ANDERSON Assistant Secretary Of Enrollments 425-525-5392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: AK 400157) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-02-26 |