| NPI | 1740569664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE MCCORMICK Clinical Director 360-452-4062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WA 603088356) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2016-06-17 |