MEDICARE: CHUGIAK SENIOR CITIZENS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	121981	AK
2	261QA0600X	Adult Day Care Clinic/Center	121981

General Provider Information

NPI Number	:	1922121789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHUGIAK SENIOR CITIZENS, INC.

Provider Business Mailing Address
First Line	:	22424 N BIRCHWOOD LOOP ROAD
Second Line	:
City	:	WASILLA
State	:	AK
Zip	:	99567-0000
Country	:	US
Telephone Number	:	907-688-2678
Fax Number	:	907-688-1319

Provider Business Practice Location Address
First Line	:	22424 N BIRCHWOOD LOOP ROAD
Second Line	:
City	:	WASILLA
State	:	AK
Zip	:	99567-0000
Country	:	US
Telephone Number	:	907-688-2678
Fax Number	:	907-688-1319

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. LINDA HENDRICKSON
Credential	:
Telephone Number	:	907-688-2678

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	09/11/2025

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