| NPI | 1689133225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FE COMON Owner/Administrator 907-222-5027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-03-13 |