Healthcare Provider Details

I. General information

NPI: 1790696730
Provider Name (Legal Business Name): MEADOW LAKES ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4553 W AMANDA DR
WASILLA AK
99623-1046
US

IV. Provider business mailing address

2731 E BEECH WAY
WASILLA AK
99654-7412
US

V. Phone/Fax

Practice location:
  • Phone: 907-414-9332
  • Fax:
Mailing address:
  • Phone: 907-414-9332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: APRIL ANN APRIL
Title or Position: ADMIN/OWNER
Credential:
Phone: 907-414-9332