| NPI | 1124078019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE NIEMI Finance 907-543-9852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2018-11-27 |