| NPI | 1831594068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC JENSEN Controller 360-236-7170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA LH00003670) |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2019-12-27 |