| NPI | 1962127399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BROWN Senior Dir. Of Medicaid Operations 907-891-6954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-10-07 |
| Last Update Date | 2022-10-07 |