| NPI | 1770839110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTHER PARILLA JUAN Administrator 907-770-6268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AK 100938) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2012-08-02 |