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General NPI Number Information
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NPI Number | 1811132327
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Entity Type | Organization
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Legal Business Name | HARBOR LIGHTS HOUSE ASSISTED LIVING, INC.
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 12/12/2008
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Provider Practice Location Address
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Address Line | 39326 HALLELUJAH TRAIL DRIVE
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City | SOLDOTNA
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State | AK
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Zip | 99669
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Country | US
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Telephone | 907-260-3646
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Fax |
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Provider Business Mailing Address
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Address Line | 39355 DUDLEY AVE
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City | SOLDOTNA
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State | AK
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Zip | 99669-8603
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Country | US
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Telephone | 907-262-5355
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOANNE LORANE REED
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Credential |
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Telephone | 907-262-5355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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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 | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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