| NPI | 1821141136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA A. IKE Program Manager 509-865-5121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA 39014200) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |