NPI | 1689757411 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN DERUYTER Clinical Director 907-451-8208 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health (Licence: AK 298949) | |
103TF0000X Psychologist, Family | |
Enumeration Date | 2006-10-23 |
Last Update Date | 2025-09-11 |