Organization
TIDES LLC
Active
Organization
TIDES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE E FRANZONI (ADMINISTRATOR)
(907) 723-0339
Entity
Organization
Contact information
Practice address
3110 NOWELL AVE, JUNEAU, AK 99801-1932
(907) 723-0339
Mailing address
3110 NOWELL AVE, JUNEAU, AK 99801-1932
(907) 723-0339
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
1007677
AK
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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