| NPI | 1174690309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN OHMER Director 907-772-3332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AK 282463) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AK 282463) |
| 1041C0700X Social Worker, Clinical (Licence: AK 282463) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2010-07-22 |