| NPI | 1063871192 |
|---|---|
| Doing Business As | NONDALTON BSD CLINIC |
| Entity Type | Organization |
| Authorized Contact | RONALD LEE OLSON VP Finance 907-729-4939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AK 20467) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |