| NPI | 1326793415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER IBARDO Owner 907-929-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-02-16 |
| Last Update Date | 2022-02-16 |