Organization
SHANGRI'LA RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARMA SPARKS BROWN (OWNER/OPERATOR)
(907) 687-7775
Entity
Organization
Contact information
Practice address
782 ADVENTURE RD, FAIRBANKS, AK 99712-3330
(907) 687-7775
Mailing address
PO BOX 56776, NORTH POLE, AK 99705-1776
(907) 687-7775
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
AK
253Z00000X
In Home Supportive Care Agency
—
AK
Other
Enumeration date
04/20/2012
Last updated
04/20/2012
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