Organization
ALASKA LIFE GROUP HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY CANNON (ADMINISTRATOR)
(907) 854-0443
Entity
Organization
Contact information
Practice address
23812 DOLLY AVE, CHUGIAK, AK 99567-5577
(907) 854-0443
Mailing address
PO BOX 670590, CHUGIAK, AK 99567-0590
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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