WASILLA GROUP HOME LLC NPI 1699320127

NPI Information

WASILLA GROUP HOME LLC is an assisted living and mental illness assisted living facility in Wasilla, AK. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. WASILLA GROUP HOME LLC NPI is 1699320127. The provider is registered as an organization entity type.

The provider's business location address is:

3660 W LYNN DR
WASILLA, AK
ZIP 99654-949
Phone: (907) 357-0102
Fax: (907) 631-4253

The provider's authorized official is Renne Champagne .
The authorized official title is Owner Administrator and has the following contact phone number (907) 357-0102.

The enumeration date for this NPI number is 8/1/2019 and was last updated on 8/1/2019.

Taxonomy Codes

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