| NPI | 1447635867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN SENSENIG Manager 907-306-4161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MT C264221) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2016-02-09 |