Organization
ORCHARD ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA TIARA FULTON (OWNER, ADMINISTRATOR)
(907) 306-4173
Entity
Organization
Contact information
Practice address
400 W 76TH AVE, #105, ANCHORAGE, AK 99518-2551
(907) 306-4173
Mailing address
400 W 76TH AVE, #105, ANCHORAGE, AK 99518-2551
(907) 306-4173
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
101114
AK
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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