Organization
MY DAUGHTER AND ME ALH, II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY LOUISE LUNDY LPN (ADMINISTRATOR)
(907) 830-3055
Entity
Organization
Contact information
Practice address
2202 ROOSEVELT DR, ANCHORAGE, AK 99517-3040
(907) 677-7767
(907) 677-7767
Mailing address
2202 ROOSEVELT DR, ANCHORAGE, AK 99517-3040
(907) 677-7767
(907) 677-7767
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
923799
AK
347C00000X
Private Vehicle
923799
AK
385H00000X
Respite Care
923799
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347C0000X
—
AK
05
—
385H0000X
—
AK
Enumeration date
04/14/2009
Last updated
12/21/2009
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