Organization
RESIDENCE XII
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER KILWINE (EXECUTIVE ASSISTANT)
(425) 823-8844
Entity
Organization
Contact information
Practice address
12029 113TH AVE NE, KIRKLAND, WA 98034-6901
(425) 823-8844
(425) 820-2371
Mailing address
12029 113TH AVE NE, KIRKLAND, WA 98034-6901
(425) 823-8844
(425) 820-2371
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
17005200
WA
Other
Enumeration date
07/21/2006
Last updated
07/28/2008
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