Organization
THE MOOSE SHACK
Active
Organization
THE MOOSE SHACK
Active
Other names
Autumn Sunrise
Organization subpart
No
Provider details
NPI number
Authorized official
CANDIS DENISE BISHOP (OWNER)
(907) 351-0569
Entity
Organization
Contact information
Practice address
19216 CITATION RD, EAGLE RIVER, AK 99577-8416
(907) 351-0569
Mailing address
19216 CITATION RD, EAGLE RIVER, AK 99577-8416
(907) 351-0569
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
101077
AK
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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