Provider First Line Business Practice Location Address:
201 DEERMOUNT ST., K.I.C.-BEHAVIORAL HEALTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KETCHIKAN
Provider Business Practice Location Address State Name:
AK
Provider Business Practice Location Address Postal Code:
99901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
907-228-9203
Provider Business Practice Location Address Fax Number:
800-856-3318
Provider Enumeration Date:
07/07/2020