NPI | 1114050911 |
---|---|
Other Name | JAKE'S PLACE |
Entity Type | Organization |
Authorized Contact | ROBERT J CLARK Chief Executive Officer 907-842-5201 |
Organization Subpart ? | No |
Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
Enumeration Date | 2007-03-13 |
Last Update Date | 2013-04-04 |