| NPI | 1336784347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES T GLANTON CEO 907-422-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2022-08-12 |