Organization
FORAYS
Active
Other names
Northern Comfort
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRAD ANDERSON (OWNER)
(706) 267-4433
Entity
Organization
Contact information
Practice address
2800 N LAGOON DR, WASILLA, AK 99654-9353
(907) 746-6493
Mailing address
2800 N LAGOON DR, WASILLA, AK 99654-9353
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101473
—
AK
Enumeration date
12/28/2021
Last updated
12/30/2021
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