| NPI | 1982726071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT C MARTIN Administrator 360-681-8463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA 0508600) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |