| NPI | 1659966117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAWYER RYAN SALAMEH Owner 907-299-8733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-06 |
| Last Update Date | 2021-03-06 |