THE MOOSE SHACK NPI 1629472683

NPI Information

THE MOOSE SHACK is an assisted living facility in Eagle River, AK. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. THE MOOSE SHACK NPI is 1629472683. The provider is registered as an organization entity type.
The provider Is Doing Business As Autumn Sunrise.

The provider's business location address is:

19216 CITATION RD
EAGLE RIVER, AK
ZIP 99577-416
Phone: (907) 351-0569

The provider's authorized official is Candis Denise Bishop .
The authorized official title is Owner and has the following contact phone number (907) 351-0569.

The enumeration date for this NPI number is 10/20/2014 and was last updated on 10/20/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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