Organization
KODIAK ISLAND ASSISTED LIVING, LLC
Active
Other names
Kodiak Island Assisted Living, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY JEAN V SILVA (ADMINISTRATOR)
(915) 841-1117
Entity
Organization
Contact information
Practice address
1814 SIMEONOF ST, KODIAK, AK 99615-6517
(915) 841-1117
Mailing address
1814 SIMEONOF ST, KODIAK, AK 99615-6517
(915) 841-1117
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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