| NPI | 1184963225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE DENNISE RAMOS Administrator 907-310-6434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AK 100909) |
| Enumeration Date | 2013-02-09 |
| Last Update Date | 2013-02-09 |