Provider Demographics
NPI:1043454408
Name:NATALIYAS CARE SERVICES
Entity Type:Organization
Organization Name:NATALIYAS CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHUCHKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-357-5431
Mailing Address - Street 1:PO BOX 872501
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99687-2501
Mailing Address - Country:US
Mailing Address - Phone:907-357-5431
Mailing Address - Fax:907-357-5421
Practice Address - Street 1:1450 N CRESTE FORIS ST STE A
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-5651
Practice Address - Country:US
Practice Address - Phone:907-357-5431
Practice Address - Fax:907-357-5421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK917716385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care