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SUE'S SOURDOUGH ASSISTED LIVING LLC NPI 1114140456


NPI Information

NPI: 1114140456
Provider Name: SUE'S SOURDOUGH ASSISTED LIVING LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
14650 PARK HILLS DR
ANCHORAGE, AK
ZIP 99516
Phone: (907) 345-1854
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SUE'S SOURDOUGH ASSISTED LIVING LLC is an assisted living facility in Anchorage, 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. SUE'S SOURDOUGH ASSISTED LIVING LLC NPI is 1114140456. The provider is registered as an organization entity type.

The provider's business location address is:

14650 PARK HILLS DR
ANCHORAGE, AK
ZIP 99516-241
Phone: (907) 345-1854

The provider's authorized official is Susan Cress .
The authorized official title is Direct Owner and has the following contact phone number (907) 345-1854.

The enumeration date for this NPI number is 4/11/2007 and was last updated on 8/22/2020.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living Facility100415ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1RL3740MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.