| NPI | 1801509260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNETTA ANN HAGEL-GRANT Owner 907-602-2629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2022-12-30 |