| NPI | 1932286101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSY JEAN ANDERSON Owner/Administrator 360-373-0155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: WA CP00002242) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP00002242) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-06-18 |