Organization
NORTHERN LIGHTHOUSE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
S. M. METTLER (ADMINISTRATOR)
(907) 242-5282
Entity
Organization
Contact information
Practice address
307 E 24TH AVE, ANCHORAGE, AK 99503-2105
(907) 242-5282
Mailing address
PO BOX 241428, ANCHORAGE, AK 99524-1428
(907) 242-5282
(907) 276-0104
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
000250
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RL2466
RESIDENTIAL LIVING
AK
Enumeration date
03/26/2007
Last updated
12/29/2009
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