| NPI | 1508189945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA URENA Owned 907-346-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AK 928682) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2010-03-11 |