| NPI | 1619590833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNADITH METUCUA LLOREN-PARIS Designee 907-519-5067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-05-21 |