| NPI | 1669214524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA CLARK Co Owner 509-209-9664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-11 |