Organization
ROCKING YEARS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN POWELL (ADMINISTRATOR)
(907) 374-5816
Entity
Organization
Contact information
Practice address
1913 JACK ST, FAIRBANKS, AK 99709-4111
(907) 374-5816
Mailing address
1913 JACK ST, FAIRBANKS, AK 99709-4111
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
000054
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL4578
—
AK
Enumeration date
04/24/2007
Last updated
07/15/2008
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