| NPI | 1689757411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DERUYTER Clinical Director 907-451-8208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AK 298949) |
| 103TF0000X Psychologist, Family | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |