| NPI | 1578455820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELVIN PACE CEO 907-301-6652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2025-07-18 |
| Last Update Date | 2025-07-18 |