| NPI | 1245411966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE V VIZCOCHO Owner/Program Administrator 907-336-1820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: AK 746422) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2007-11-21 |