| NPI | 1376520692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KAECH CEO 907-581-8658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AK 147861) |
| 122300000X Dentist (Licence: AK 147861) | |
| 363A00000X Physician Assistant (Licence: AK 147861) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2018-10-31 |