Organization
GRANNY'S DOWNHOME CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATSY JEAN BERRY LPN (OWNER)
(907) 357-5803
Entity
Organization
Contact information
Practice address
2200 E WOLVERINE CIR, WASILLA, AK 99654-2708
(907) 357-5803
(907) 357-5813
Mailing address
2200 E WOLVERINE CIR, WASILLA, AK 99654-2708
(907) 357-5803
(907) 357-5813
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
100513
AK
Other
Enumeration date
05/23/2013
Last updated
05/23/2013
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