| NPI | 1376981696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL JOHNSON Co Owner/Manager 907-456-1434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK 761) |
| Enumeration Date | 2013-06-08 |
| Last Update Date | 2014-03-03 |