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