| NPI | 1356113302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISICHEI SAMUEL ANENE Program Manager 907-351-4814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2023-11-01 |