| NPI | 1417503764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BODNAR Executive Director 907-376-4534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2019-08-13 |