| NPI | 1891570214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW MOORE Owner 360-844-0462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2023-09-04 |