Organization
ROOTED RAVEN SUPPORTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BABIN (OWNER)
(907) 491-1661
Entity
Organization
Contact information
Practice address
48765 EILEEN ST, NIKISKI, AK 99611-6123
(907) 491-1661
Mailing address
48765 EILEEN ST, NIKISKI, AK 99611-6123
(907) 491-1661
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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