| NPI | 1295581981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HERMOSURA FABRO Administrator 907-359-2871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-04-24 |