| NPI | 1710619994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON RACHEL MCGRATH Owner And Provider 907-230-6619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-06-27 |