| NPI | 1932712882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY WEST Chief Executive Officer 907-733-9230 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |