NPI | 1780053868 |
---|---|
Entity Type | Organization |
Authorized Contact | JODI MARIE LIETZ Counselor 360-608-1010 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: OR R3860) |
Enumeration Date | 2015-09-18 |
Last Update Date | 2015-09-18 |