| NPI | 1013644079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA PENTECOSTES Administrator 907-444-1519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2022-08-01 |
| Last Update Date | 2022-08-01 |