Organization
ABBY ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA FULTON (OWNER)
(907) 306-4173
Entity
Organization
Contact information
Practice address
1781 S ABBY BLVD, WASILLA, AK 99654-8448
(907) 306-4173
Mailing address
400 W 76TH AVE APT 105, ANCHORAGE, AK 99518-2551
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1681005
—
AK
05
—
1724270
—
AK
Enumeration date
01/04/2022
Last updated
01/04/2022
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