Organization
EAGLES WINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY OPPERMAN (OWNER/ADMINISTRATOR)
(907) 978-5844
Entity
Organization
Contact information
Practice address
109 E 5TH AVE, NORTH POLE, AK 99705-7774
(907) 385-0268
(907) 385-0275
Mailing address
PO BOX 57425, NORTH POLE, AK 99705-2425
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
100924
AK
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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