| NPI | 1093538456 |
|---|---|
| Doing Business As | KODIAK ISLAND ASSISTED LIVING, LLC |
| Entity Type | Organization |
| Authorized Contact | MARY JEAN V SILVA Administrator 915-841-1117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2024-11-04 |
| Last Update Date | 2024-11-04 |