Organization
RESPECT YOUR ELDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNNIE DAVIS (CO-OWNER)
(907) 775-0345
Entity
Organization
Contact information
Practice address
2301 COLLEEN ST, PALMER, AK 99645
(907) 745-3687
(907) 746-3687
Mailing address
PO BOX 2422, PALMER, AK 99645
(907) 745-3687
(907) 746-3687
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
230512
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HC6167
SERVICE PROVIDER #
AK
Enumeration date
04/10/2007
Last updated
07/31/2008
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