| NPI | 1124110796 |
|---|---|
| Other Name | BEHAVIORAL HEALTH UNDER 1115 WAIVER |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN J WRIGHT CEO 907-260-7314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2023-04-25 |