| NPI | 1588255632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON J BENJAMIN CFO 907-474-0890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2021-02-01 |
| Last Update Date | 2021-02-01 |