| NPI | 1811199169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN DENISE SOURS Program Coordinator 907-442-7582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: AK 400278) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |