| NPI | 1598013096 |
|---|---|
| Other Name | GRANVILE HOME |
| Entity Type | Organization |
| Authorized Contact | DRENDA M TIGNER CEO 907-456-6445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AK 1639) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-11-01 |