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Organization

SUE'S SOURDOUGH ASSISTED LIVING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SUSAN CRESS (DIRECT OWNER)
(907) 345-1854
Entity
Organization

Contact information

Practice address
14650 PARK HILLS DR, ANCHORAGE, AK 99516-4241
(907) 345-1854
Mailing address
PO BOX 110041, ANCHORAGE, AK 99511-0041
(907) 345-1854

Taxonomy

Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
100415
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
HC8560
AK
Enumeration date
04/17/2007
Last updated
08/22/2020
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