| NPI | 1497425318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELANA RENEE MALONE Owner 907-602-0371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2021-09-14 |