| NPI | 1992329304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER LYNN ORTIZ Program Administrator 907-952-3966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2020-08-19 |