| NPI | 1801306899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL C BOSSART Owner 907-205-7441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2024-11-13 |