| NPI | 1730571142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MCCULLOUGH CAMPBELL Contact Person 206-453-4882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA CG60506476) |
| Enumeration Date | 2015-02-21 |
| Last Update Date | 2015-02-21 |