| NPI | 1265619837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESITA SERGIO CORRAL Administrator 907-336-4635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AK 167) |
| Enumeration Date | 2008-01-26 |
| Last Update Date | 2008-01-26 |