| NPI | 1881942035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA KRISTINA GERVOL CREYDT Clinical Director 360-990-3848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2018-01-02 |