| NPI | 1629299631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODOLFO D. REGACHO Representative 907-830-8706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-08-07 |