| NPI | 1215700554 |
|---|---|
| Doing Business As | INTENSIVE HOME BASED TREATMENT |
| Entity Type | Organization |
| Authorized Contact | JONA TETZLOFF Manager Of Revenue Cycle 907-729-5083 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |