| NPI | 1891366068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA SHEPEL Contracting & Credentialing Manager 425-214-9321 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2024-04-29 |