| NPI | 1881993749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ANN BARRETT-GODWIN Owner/Designee 907-746-3442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AK 942851) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2011-03-17 |