Organization
FULL LIFE LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN BRENT WOOD (PROGRAM ADMINISTRATOR)
(907) 539-5108
Entity
Organization
Contact information
Practice address
12309 GARA DR, KODIAK, AK 99615-9317
(907) 487-2181
Mailing address
12309 GARA DR, KODIAK, AK 99615-9317
(907) 539-5108
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/07/2020
Last updated
02/07/2020
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