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, Intellectual and/or Developmental Disabilities (Licence: AK 1002547) |
Enumeration Date | 2014-06-24 |
Last Update Date | 2014-06-24 |