| NPI | 1073259636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN ROSE KRAUS Cro 907-313-4566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2025-07-11 |