| NPI | 1477802197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN SHERBONDY Administrator/Owner 907-435-3938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2012-09-10 |