Organization
LAKE HAVEN HOMES, LLC
Active
Organization
LAKE HAVEN HOMES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHA L SOMMERVILLE (ADMINISTRATOR/OWNER)
(907) 841-1380
Entity
Organization
Contact information
Practice address
7781 W DEAN DR, WASILLA, AK 99623-0824
(907) 841-1380
(907) 841-1380
Mailing address
7362 W PARKS HWY # 638, WASILLA, AK 99623-9300
(907) 841-1380
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
100183
AK
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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