Organization
COLONY MANOR CREEKSIDE ASSISTED LIVING HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHAN DAHL (ADMINISTRATOR)
(907) 373-1880
Entity
Organization
Contact information
Practice address
1998 CREEKSIDE DR, WASILLA, AK 99654
(907) 373-1880
(907) 373-1820
Mailing address
PO BOX 870469, WASILLA, AK 99687
(907) 373-1880
(907) 373-1820
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
000268
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL97971
—
AK
Enumeration date
04/21/2010
Last updated
04/21/2010
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