NPI | 1235770298 |
---|---|
Entity Type | Organization |
Authorized Contact | CAROLYN COOPER Owner/Operator 907-374-7076 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2019-10-01 |
Last Update Date | 2024-10-31 |