| NPI | 1790997922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTURO MEMITA EVANGELISTA President 907-743-0654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: AK 100317) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |