| NPI | 1013205608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EFFIE JUNE MOE Camp Counselor 907-452-8251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: AK 3245S0500X) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2011-07-15 |