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