Organization
AOFALASKA LLC
Active
Other names
Mountain Vista ALH
Organization subpart
No
Provider details
NPI number
Authorized official
DARCY L HIETT (ADMINISTRATOR/MEMBER)
(907) 244-9504
Entity
Organization
Contact information
Practice address
19412 FIRST ST, EAGLE RIVER, AK 99577
(907) 244-9504
Mailing address
19412 FIRST ST, EAGLE RIVER, AK 99577
(907) 244-9504
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
100803
AK
Other
Enumeration date
02/27/2012
Last updated
02/27/2012
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