MEDICARE: SUSAN TAYLOR-MCLAUGHLIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3104A0625X	Assisted Living Facility (Mental Illness)	100815	AK

General Provider Information

NPI Number	:	1740706548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN TAYLOR-MCLAUGHLIN

Provider Business Mailing Address
First Line	:	9113 JEWEL TERRACE ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-5149
Country	:	US
Telephone Number	:	907-332-2203
Fax Number	:	907-332-2205

Provider Business Practice Location Address
First Line	:	9113 JEWEL TERRACE ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99502-5149
Country	:	US
Telephone Number	:	907-332-2203
Fax Number	:	907-332-2205

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2017
Last Update Date	:	01/15/2026

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