| NPI | 1912112244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY JONES Director 360-427-9006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |