| NPI | 1710667019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN CLAIRE LONG Owner 425-405-2216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2023-07-21 |