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General NPI Number Information
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NPI Number | 1538842778
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Entity Type | Organization
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Legal Business Name | BOSTON CONSULTS OF ALASKA, LLC
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 3265 E MERIDIAN PARK LOOP
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City | WASILLA
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State | AK
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Zip | 99654-7474
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Country | US
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Telephone | 907-355-4084
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Fax |
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Provider Business Mailing Address
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Address Line | 7362 W PARKS HWY # 801
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City | WASILLA
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State | AK
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Zip | 99623-9300
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Country | US
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Telephone | 907-355-4083
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN BOSTON
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Credential | DO
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Telephone | 907-355-4084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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