| NPI | 1689450223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA DEPWEG Owner 907-727-4656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2023-09-07 |