| NPI | 1457552903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL KILGORE Executive Director 907-455-4567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2008-08-04 |