| NPI | 1992314215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE ANN AVILA Ryc Executive Administrative Assist 907-617-6145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |