| NPI | 1841641388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL H JOHNSON Sole Member 907-422-7504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AK 1390) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2016-06-27 |