Organization Name: | 5-D CORPORATION |
NPI Number: | 1679697783 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MERRI BELLE DIAS (ADMINISTRATOR) |
Mailing Address: | 2800 N Lagoon Dr. Wasilla |
State: | AK US |
Postal Code: | 99654 |
Phone Number: | 9077466493 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | 241 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |