| NPI | 1659700797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA FORD Owner 253-278-8444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 60254815) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |