Organization
KODIAK ISLAND ASSISTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY JEAN V SILVA PHD (ADMINSTRATOR)
(915) 841-1117
Entity
Organization
Contact information
Practice address
1814 SIMEONOF ST, KODIAK, AK 99615-6517
(915) 841-1117
Mailing address
914 THORSHEIM ST, KODIAK, AK 99615-6165
(915) 841-1117
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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