| NPI | 1821543570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN JO GALLAWAY Owner 206-457-9291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA MC 60301591) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |