| 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 |