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General NPI Number Information
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NPI Number | 1639247810
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Entity Type | Organization
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Legal Business Name | NORTHERN LIVING CENTERS, LLC
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2795 W STONEBRIDGE DR
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City | WASILLA
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State | AK
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Zip | 99654-0742
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Country | US
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Telephone | 907-376-3821
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 W. RIVERDELL DR.
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City | WASILLA
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State | AK
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Zip | 99654-9704
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Country | US
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Telephone | 907-376-3821
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAREN L RHOADES
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Credential |
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Telephone | 907-376-3821
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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 | 723017
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License Number State | AK
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