| NPI | 1558980706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARELEE JOHNSON Owner/ Program Administrator 907-315-2755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-04-08 |