| NPI | 1922332188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA LEWIS Administrator 360-314-6507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 06158100) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2016-08-16 |