| NPI | 1902439680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARL SODERSTROM CEO 907-313-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2023-05-11 |