| NPI | 1184941866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN DAHL Administrator 907-373-1880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: AK 000196) |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2010-04-21 |