OrganizationActive
Wolverine Academy, LLC
NPI 1881993749 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Palmer, AK
Provider details
- NPI number
- 1881993749
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Kelly Barrett-Godwin, Owner/Designee(907) 746-3442
- License
- 942851 (AK)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 942851 (AK)
Residential Treatment Facilities
Practice location
15700 E Clark Rd
Palmer, AK 99645-8705
Phone: (907) 746-3442
Fax: (907) 746-4847
Approximate (ZIP-level) locationGet directions
Mailing address
15700 E Clark Rd
Palmer, AK 99645-8705
Registry dates
- Enumerated
- 2011-03-17
- Last updated
- 2011-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.