| NPI | 1598397911 |
|---|---|
| Other Name | 1115 SUD WAIVER |
| Entity Type | Organization |
| Authorized Contact | JOSEPH WANNER Chief Financial Officer 907-796-8900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2023-11-21 |