Provider Demographics
NPI:1326201930
Name:WASILLA AREA SENIORS INC
Entity Type:Organization
Organization Name:WASILLA AREA SENIORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-206-8795
Mailing Address - Street 1:1301 S CENTURY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654
Mailing Address - Country:US
Mailing Address - Phone:907-206-8800
Mailing Address - Fax:907-802-4788
Practice Address - Street 1:1301 S CENTURY CIRCLE
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654
Practice Address - Country:US
Practice Address - Phone:907-206-8800
Practice Address - Fax:907-802-4788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK720822261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care