| NPI | 1780279919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA LINDSEY Operations Support Specialist 907-463-6852 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2021-03-24 |