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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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