| NPI | 1952817454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE BOYD Owner 360-742-0418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WA LF60797974) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WA LF60797974) |
| Enumeration Date | 2017-12-19 |
| Last Update Date | 2021-07-15 |