| NPI | 1487056263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN LEANNE FUGETT Business Administrator 907-222-2503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AK 1004627) |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2018-03-02 |