| NPI | 1134870330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEA MINA Administrator 907-727-5986 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-01-10 |