NPI | 1669082392 |
---|---|
Entity Type | Organization |
Authorized Contact | JONATHAN VAN RAVENSWAAY Executive Director 907-868-1105 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
Enumeration Date | 2020-08-07 |
Last Update Date | 2020-08-07 |