| NPI | 1972946598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA DAWN PAULUS Owner 360-571-2050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA AP30004268) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2013-04-12 |