| NPI | 1891621124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIE LYNN JOHNSON Owner/Provider 509-210-1513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2026-06-23 |
| Last Update Date | 2026-06-23 |