Organization
ALDERGROVE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN SHERBONDY (ADMINISTRATOR/OWNER)
(907) 435-3938
Entity
Organization
Contact information
Practice address
41045 DENNY LANE, HOMER, AK 99603
(907) 435-3938
Mailing address
PO BOX 1954, HOMER, AK 99603-1954
(907) 435-3938
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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