| NPI | 1922247931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN L WINGFIELD Owner/Administrator 907-258-4663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: AK 100218) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: AK 100218) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2010-05-25 |