| NPI | 1104140185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERDIE TAN ODRON Owner/Administrator 907-947-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AK 100792) |
| Enumeration Date | 2010-03-20 |
| Last Update Date | 2010-03-20 |