| NPI | 1043982671 |
|---|---|
| Doing Business As | TRIBAL- CHILD & FAMILY OUTPATIENT SERVICES(WEST) |
| Doing Business As | BH 1115-CHILD & FAMILY OUTPATIENT SERVICES (WEST) |
| Entity Type | Organization |
| Authorized Contact | RONALD LEE OLSON Executive Vice President Finance 907-729-4939 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2023-09-19 |