| NPI | 1972992139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOELLE SUSANN SEAUNIER Owner 360-789-9555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA LH 60184902) |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2017-03-20 |