Organization
SEVERSON LLC
Active
Other names
Alaska Independent & Transitional Living ALH
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD LEE SEVERSON (ADMINISTRATOR)
(907) 222-1153
Entity
Organization
Contact information
Practice address
8531 LITTLE DIPPER AVE, ANCHORAGE, AK 99504-4238
(907) 317-5050
Mailing address
PO BOX 210101, ANCHORAGE, AK 99521-0101
(907) 222-1153
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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