Organization
NORTHERN LIGHTHOUSE DAY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JO METTLER (ADMINISTRATOR)
(907) 398-2939
Entity
Organization
Contact information
Practice address
403 E 24TH AVE, ANCHORAGE, AK 99503-2107
(907) 398-2939
Mailing address
PO BOX 241428, ANCHORAGE, AK 99524-1428
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
NONE ISSUED BY STATE
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HC0349
—
AK
Enumeration date
04/24/2007
Last updated
08/22/2020
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