| NPI | 1902381940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDAT M MARENAH Administrator 907-278-1754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |