| NPI | 1619110004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LOUISE LUNDY Administrator 907-830-3055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: AK 923799) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: AK 923799) |
| 385H00000X Respite Care (Licence: AK 923799) | |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2009-12-21 |