Organization
NICHOLSONS ASSISTED LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY NICHOLSON (ADMINISTRATOR)
(907) 283-6684
Entity
Organization
Contact information
Practice address
36601 NAVIGATOR STREET, KENAI, AK 99611-0000
(907) 283-6684
Mailing address
PO BOX 2495, KENAI, AK 99611-2495
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
000116
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HC0079
—
AK
05
—
HC9955
—
AK
Enumeration date
05/01/2007
Last updated
08/27/2013
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