| NPI | 1699320127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENNE CHAMPAGNE Owner Administrator 907-357-0102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2019-08-01 |