| NPI | 1740927474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEZLEE HENRY Owner 907-215-8153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-05-15 |
| Last Update Date | 2024-03-05 |