Organization
GOLDEN AGERS HOMECARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WESLEY SHERMAN ALLEN (OWNER)
(907) 631-4222
Entity
Organization
Contact information
Practice address
591 E SUSITNA AVE, WASILLA, AK 99654-8127
(907) 631-4222
(907) 631-4222
Mailing address
591 E SUSITNA AVE, WASILLA, AK 99654-8127
(907) 631-4222
(907) 631-4222
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
100897
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100897
—
AK
Enumeration date
04/05/2012
Last updated
04/05/2012
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