| NPI | 1225747215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY MOORE Owner And Employed Provider 907-931-8618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2023-02-02 |