Organization
THE CHILDREN'S PLACE
Active
Other names
The Children's Place
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE RENEE BAYLESS (EXECUTIVE DIRECTOR)
(907) 357-5157
Entity
Organization
Contact information
Practice address
1021 N LUCILLE ST, WASILLA, AK 99654-6405
(907) 357-5157
(907) 357-5159
Mailing address
PO BOX 871788, WASILLA, AK 99687
(907) 357-5157
(907) 357-5159
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
271872
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD1999
—
AK
Enumeration date
08/06/2009
Last updated
05/01/2019
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