Organization
SHINING STAR ASSIST LIVING
Active
Other names
Shining Star assist living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL MICHEAL WORMAN (OWNER)
(907) 687-5944
Entity
Organization
Contact information
Practice address
2941 WESTGATE PL, FAIRBANKS, AK 99709-4747
(907) 687-5944
Mailing address
2941 WESTGATE PL, FAIRBANKS, AK 99709-4747
(907) 687-5944
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
AK
Other
Enumeration date
06/01/2011
Last updated
06/01/2011
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