| NPI | 1265047518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERBERT SCHWAGER Director 907-715-7391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-16 |