| NPI | 1689026064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY CARSSOW Director 1907-235-3738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AK 106280) |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2016-07-08 |