| NPI | 1740531656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY ISSAC CEO 907-452-8251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2012-10-02 |