Organization Name: | STONE BROOK INN INC |
NPI Number: | 1407073463 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AUDRA HEDMAN (PRESIDENT-ADMINISTRATOR) |
Mailing Address: | 48420 Moose Run Rd Soldotna |
State: | AK US |
Postal Code: | 99669 |
Phone Number: | 9072604498 |
Fax Number: | 9072604498 |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |