| NPI | 1306483755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA NELSON Executive Director 907-452-4222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |