| NPI | 1053679514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI LYNN FELTON Sole Member/ Owner 907-952-6260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AK 700) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2012-05-02 |