| NPI | 1114223476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE MEWBORN Owner 907-602-0818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AK 941631) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2011-02-04 |