| NPI | 1255517975 |
|---|---|
| Doing Business As | BSD- FASD CLINIC |
| Entity Type | Organization |
| Authorized Contact | RONALD LEE OLSON Executive Vice President Finance 907-729-4939 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: AK 20467) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AK 20467) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2024-04-24 |