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 |