| NPI | 1477976561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KILPATRICK Owner/Designee 907-978-2316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: AK 101028) |
| Enumeration Date | 2014-01-27 |
| Last Update Date | 2014-01-27 |