Organization
O'BIES ADOBE, LLC
Active
Other names
O'Bies Adobe, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES EDWARD O'BRYAN JR. (OWNER/ADMINISTRATOR)
(907) 244-6929
Entity
Organization
Contact information
Practice address
1790 N CENTURIAN PL APT 3, WASILLA, AK 99654-5470
(907) 244-6929
Mailing address
4128 E COUNTRY FIELD CIR, WASILLA, AK 99654-6665
(907) 244-6929
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
10078143
AK
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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