| NPI | 1457967481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISATOU JAHATEH Owner 907-360-2199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |