| NPI | 1164166088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER RICHARD AUGUSTIN President 907-529-0103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-08-23 |