Healthcare Provider Details

I. General information

NPI: 1023158284
Provider Name (Legal Business Name): VLADI & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 01/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4614 E 8TH AVE
ANCHORAGE AK
99508-2716
US

IV. Provider business mailing address

4614 E 8TH AVE
ANCHORAGE AK
99508-2716
US

V. Phone/Fax

Practice location:
  • Phone: 907-258-5303
  • Fax: 907-258-5303
Mailing address:
  • Phone: 907-258-5303
  • Fax: 907-258-5303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number713027
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number713027
License Number StateAK

VIII. Authorized Official

Name: VLADIMIR VISHNEVETSKI
Title or Position: AGENCY DIRECTOR
Credential:
Phone: 907-258-5303