| NPI | 1568065431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA LYNNE RUKOVISHNIKOFF Administrator 907-570-2333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2020-11-20 |