| NPI | 1366990202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY B JONES Administrator/Owner 907-764-8331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AK 100619) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2016-09-20 |