| Organization Name: | ALICE SHANTZ |
| NPI Number: | 1013137348 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALICE S SHANTZ (OWNER) |
| Mailing Address: | 473 Ridgecrest Drive Box 1915 Bethel |
| State: | AK US |
| Postal Code: | 995591915 |
| Phone Number: | 9075433232 |
| Fax Number: | 9075431443 |
| NPI Enumeration Date: | 04/27/2007 |
| NPI Last Update Date: | 09/20/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 177F00000X |
| License Number: | 432920 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Lodging |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. |