Healthcare Provider Details

I. General information

NPI: 1982451886
Provider Name (Legal Business Name): EMERALD VIEW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2024
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 W 31ST AVE
ANCHORAGE AK
99503-3678
US

IV. Provider business mailing address

12570 OLD SEWARD HWY STE 204
ANCHORAGE AK
99515-3532
US

V. Phone/Fax

Practice location:
  • Phone: 907-830-8212
  • Fax:
Mailing address:
  • Phone: 907-830-8212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE DRAYTON
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 907-830-8212