| NPI | 1376368829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRIETTA EMOKIDI Owner/Provider 907-317-1703 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2024-11-20 |
| Last Update Date | 2024-11-20 |