| NPI | 1063702546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERLO ISANG LLANEZA Owner/Adminitration 907-522-0564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AK 100875) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2011-04-18 |