Organization
EXTENDED FAMILY ALASKA LLC
Active
Organization
EXTENDED FAMILY ALASKA LLC
Active
Other names
Extended Family Alaska LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DEON BURNS (PRESIDENT)
(907) 205-7427
Entity
Organization
Contact information
Practice address
978 PICKERING DR, FAIRBANKS, AK 99709-5770
(907) 205-7427
Mailing address
12725 LANDMARK ST # A, ANCHORAGE, AK 99515-3818
(907) 205-7427
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101264
ASSISTED LIVING HOME LICENSE
AK
Enumeration date
10/08/2018
Last updated
10/08/2018
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