| NPI | 1972668945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBEN ROMERO Owner 360-479-0853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 602-342-735) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |