| NPI | 1801168620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON L MCKENZIE Administrator 907-336-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: AK 100249) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-02-09 |