| NPI | 1780221127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELLA TITUS Business Manager 907-562-2120 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |