| NPI | 1851593925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDNA KUIPERS Director 800-733-4604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 44159) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2020-08-22 |