| NPI | 1629331863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE LAVETTE MEWBORN Owner 907-602-0818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: AK 6412530) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2012-06-22 |