| NPI | 1912270794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE F VASQUEZ Director 360-951-6304 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA LH60090934) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-02-09 |