Organization
J&J INDEPENDENT LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILLIE JO HANSEN (ADMINISTRATOR/OWNER)
(907) 715-6507
Entity
Organization
Contact information
Practice address
165 E. PARKS HWY, SUITE 106, WASILLA, AK 99654-3909
(907) 373-3953
(907) 373-3983
Mailing address
165 E PARKS HWY, SUITE 106, WASILLA, AK 99654-7059
(907) 373-3953
(907) 373-3983
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
1002558
AK
251C00000X
Developmentally Disabled Services Day Training Agency
1002558
AK
251C00000X
Developmentally Disabled Services Day Training Agency
1624210
AK
253J00000X
Foster Care Agency
—
—
310400000X
Assisted Living Facility
—
AK
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
1624210
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1624208
—
AK
05
—
1624210
—
AK
Enumeration date
09/14/2014
Last updated
09/21/2016
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