| NPI | 1255079638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES JOHNSON Quality Assurance Coordinator 907-220-6117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2022-05-25 |