Organization
NORTHERN LIVING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORY DETTY (MEMBER)
(404) 944-0041
Entity
Organization
Contact information
Practice address
2795 W STONEBRIDGE DR, WASILLA, AK 99654-0742
(907) 376-5828
Mailing address
PO BOX 243162, ANCHORAGE, AK 99524-3162
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/24/2023
Last updated
03/24/2023
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