The Moose Shack, NPI 1629281126
Assisted Living Facility in Eagle River, AK, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1629281126 |
| NPI Entity Type | Organization |
| Provider Name |
The Moose Shack
Doing Business As |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Provider Location Address | 19216 Citation Rd, Eagle River, AK, US |
| Provider Mailing Address | 19216 Citation Rd, Eagle River, AK, US, 995778416 |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | CEO Candis Denise Bishop |
| Official Position | CEO |
| Phone | 907-351-0569 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Assisted Living Facility |
| Classification | |
| Group | |
| License No. | 000277 |
| License State | AK |
| Description | 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. |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| RL09771 | AK | MEDICAID | 05 |
| 1030021 | AK | MEDICAID | 05 |
Other Providers in AK, US
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|---|---|---|---|
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RD Marcel Leon Hollis Individual |
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MRS. MPAS PA-C Kathryn Elizabeth Steer Individual |
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Catholic Social Services Organization |
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DR. DO Brian Paul Fremaux Individual |
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MS CCC SLP Christal Hays Individual |
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Morgan Dean Yaskus Individual |
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MS. Katelyn Tamara Holmberg Individual |
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DR. MD Amy Elizabeth Dressel Individual |
1600 Glacier Ave |
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Melissa Tasselli Individual |
16941 N Eagle River Loop Rd Ste 3 |
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Johanna Clemens Individual |
350 14th Ave |
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Pang Juan Lim Individual |
1550 E 74th Ave |
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Michelle Kuehn Individual |
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