| NPI | 1942578471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE WILSON Billing Manager 509-209-2777 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 251J00000X Nursing Care |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2016-02-01 |