Organization
WILLOW CREEK ASSISTED LIVING
Active
Organization
WILLOW CREEK ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBERTA ELLEN SANDOVAL (ADMINISTRATOR)
(907) 495-2999
Entity
Organization
Contact information
Practice address
23281 W. WILLOW FISHHOK RD, WILLOW, AK 99688-0558
(907) 495-2999
(907) 495-9199
Mailing address
23281 W. WILLOW FISHOOK RD, PO BOX 558, WILLOW, AK 99688-0558
(907) 495-2999
(907) 495-9199
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
100142
AK
Other
Enumeration date
11/24/2008
Last updated
11/24/2008
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