| NPI | 1275186975 |
|---|---|
| Doing Business As | BH 1115- ICM |
| Entity Type | Organization |
| Authorized Contact | LEE OLSON Executive VP Finance 907-729-4939 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2025-09-25 |