| NPI | 1982154100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KEITH HALL Owner 425-359-4588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA LW60492025) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |