| NPI | 1083332985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN AIKEY Administrator Manager 907-802-0380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 251X00000X Supports Brokerage |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2022-08-16 |