| NPI | 1790942902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS WOOTEN Tribal Chair 360-293-6404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 29140100) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2008-05-16 |