| NPI | 1780035683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANECE WILLIAMS RICHARD Owner 907-351-8438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AK 620) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |