| NPI | 1760506315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL RUTH HUNDAHL Owner 360-848-8437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 29114900) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |