| NPI | 1093120438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOCELYN P. MULLINS Owner/Administrator 907-529-8087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: AK 1002547) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |