Organization
THE MOOSE SHACK
Active
Other names
Autumn Sunrise Assisted Living Home
Organization subpart
No
Provider details
NPI number
Authorized official
CANDIS DENISE BISHOP CEO (CEO)
(907) 351-0569
Entity
Organization
Contact information
Practice address
19216 CITATION RD, EAGLE RIVER, AK 99577-8416
(907) 351-0569
(888) 291-5028
Mailing address
19216 CITATION RD, EAGLE RIVER, AK 99577-8416
(907) 351-0569
(888) 291-5028
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
000277
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030021
—
AK
05
—
RL09771
—
AK
Enumeration date
05/08/2007
Last updated
10/10/2014
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