NPI | 1699538009 |
---|---|
Entity Type | Organization |
Authorized Contact | PORTIA E. JONES CEO, Clinical Director 360-200-8552 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
251S00000X | |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2024-01-31 |
Last Update Date | 2024-01-31 |