| NPI | 1902166556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACRISTINA NITIPRAWOTO Administrator 907-301-4697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AK 100911) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |