Organization
LOUISA'S LEGACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN SAN MIGUEL CC (OWNER/OPERATOR)
(907) 771-4010
Entity
Organization
Contact information
Practice address
555 W NORTHERN LIGHTS BLVD, #234, ANCHORAGE, AK 99503-2501
(907) 771-4010
(907) 771-4020
Mailing address
PO BOX 230482, ANCHORAGE, AK 99523-0482
(907) 771-4010
(907) 771-4020
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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