| NPI | 1699987156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECILIA DE LEON Owner 907-830-0518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X (Licence: AK 436948) |
| Additional Taxonomies | 251E00000X Home Health (Licence: AK 436948) |
| 310400000X Assisted Living Facility (Licence: AK 436948) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2012-06-20 |