| NPI | 1790969509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RON BLUNK Administrator 206-744-9690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 281P00000X Chronic Disease Hospital (Licence: WA rc00017782) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WA rc00017782) |
| 284300000X Special Hospital (Licence: WA rc00017782) | |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2007-12-28 |