Organization
LILLEY LODGE 1, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRYANN GAINER MBA (ADMINISTRATOR OWNER)
(907) 347-1489
Entity
Organization
Contact information
Practice address
2330 OLD RICHARDSON HWY, NORTH POLE, AK 99705-6017
(907) 347-1489
(907) 490-0322
Mailing address
PO BOX 56709, NORTH POLE, AK 99705-1709
(907) 347-1489
(907) 490-0322
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
100797
AK
Other
Enumeration date
06/04/2010
Last updated
06/04/2010
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