| NPI | 1710379060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE M SAM Sole Proprietor 907-868-3677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AK LPC434) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2024-06-13 |