| NPI | 1720470057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK PEREBOOM Persident And CEO 253-591-0113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: WA RTF.FS.60503763) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2015-02-24 |