| NPI | 1447661301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZORA S LESUEUR Psychiatric Nurse/Clinical Nurse 907-561-5309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AK 6990) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: AK 6990) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AK 6990) | |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-05-14 |