| NPI | 1932473238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEELA M CHOPPALA-NESTOR Owner And CEO 360-448-7827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WA 200344) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA AP60035777) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA 200344) | |
| Enumeration Date | 2012-03-04 |
| Last Update Date | 2017-05-10 |