Organization
NUSTART ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELYN L WINGFIELD (OWNER/ADMINISTRATOR)
(907) 258-4663
Entity
Organization
Contact information
Practice address
729 E 9TH AVE, ANCHORAGE, AK 99501-3738
(907) 258-4663
(907) 258-4692
Mailing address
PO BOX 202744, ANCHORAGE, AK 99520-2744
(907) 258-4663
(907) 258-4692
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
100218
AK
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
100218
AK
Other
Enumeration date
02/13/2009
Last updated
05/25/2010
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