Organization
KALIEDOSCOPE ASSISTED LIVING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRA L CUPP CNA (ADMINISTRATOR)
(907) 486-8186
Entity
Organization
Contact information
Practice address
1331 MISSION RD, KODIAK, AK 99615-6583
(907) 486-8186
(907) 486-6260
Mailing address
PO BOX 3923, KODIAK, AK 99615-3923
(907) 486-8186
(907) 486-6260
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
100372
AK
Other
Enumeration date
02/05/2007
Last updated
06/25/2008
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