| NPI | 1588739015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL KILGORE Executive Director 907-455-4567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2012-10-05 |