MEDICARE: HUNNY BUNNY'S ALH, LLC

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	251C00000X	Developmentally Disabled Services Day Training Agency
2	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1982574257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNNY BUNNY'S ALH, LLC

Provider Business Mailing Address
First Line	:	725 ORION DR
Second Line	:
City	:	NORTH POLE
State	:	AK
Zip	:	99705-5089
Country	:	US
Telephone Number	:	907-691-5334
Fax Number	:

Provider Business Practice Location Address
First Line	:	2654 CARRIE LYNN DR
Second Line	:
City	:	NORTH POLE
State	:	AK
Zip	:	99705-5639
Country	:	US
Telephone Number	:	907-740-8047
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	BREANNA FOSTER
Credential	:
Telephone Number	:	907-691-5334

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/10/2025

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