NPI | 1689021776 |
---|---|
Doing Business As | TRIBAL- THE COVENANT HOUSE |
Entity Type | Organization |
Authorized Contact | RONALD LEE OLSON Executive Vice President Finance 907-729-4939 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: AK 20467) |
Enumeration Date | 2016-05-18 |
Last Update Date | 2023-09-14 |