Organization
STANNEALH INC.
Active
Other names
NONE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUISA ESTRELLA BURKE (ADMINISTRATOR)
(907) 336-4010
Entity
Organization
Contact information
Practice address
9140 SHADY BAY CIR., ANCHORAGE, AK 99507
(907) 336-4010
(907) 336-4010
Mailing address
9140 SHADY BAY CIR, ANCHORAGE, AK 99507-4917
(907) 336-4010
(907) 336-4010
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
000166
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL12713
—
AK
Enumeration date
04/06/2007
Last updated
08/22/2020
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