| NPI | 1952424269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODOLFO REGACHO Manager 907-677-1294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: AK 100385) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-08-07 |