Organization
EAGLE CREST ALH LLC
Active
Other names
Eagle Crest
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BELINDA BALDWIN (EXECUTIVE DIRECTOR)
(907) 688-0123
Entity
Organization
Contact information
Practice address
22626 CHAMBER LN, CHUGIAK, AK 99567-6155
(907) 688-0123
(907) 688-0123
Mailing address
22306 SHADOWY SPRUCE DR, CHUGIAK, AK 99567-5452
(907) 688-0123
(907) 688-0123
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
959821
AK
251S00000X
Community/Behavioral Health Agency
959821
AK
315P00000X
Intellectual Disabilities Intermediate Care Facility
959821
AK
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
959821
AK
385H00000X
Respite Care
Primary
959821
AK
Other
Enumeration date
04/12/2010
Last updated
02/15/2014
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