| NPI | 1619432937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALANNIE VONGXAY Administrator 907-891-3827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |