NPI 1508189945

Professional Care Service

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Anchorage, AK

Practice location

Address: 1743 Minerva Way Same, Anchorage, AK 99515-1490
Phone: (907) 346-4410
Fax: (907) 346-4410

Authorised official

Name: Jessica Urena
Title: Owned
Phone: (907) 346-4410

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 928682 (AK)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Alaska →

Registry record

NPI: 1508189945
Entity type: Organization
NPI issued: 11 Mar 2010
Record last updated: 11 Mar 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.