Provider Demographics
NPI:1619585692
Name:HAPPY VALLEY ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:HAPPY VALLEY ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-567-3419
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:ANCHOR POINT
Mailing Address - State:AK
Mailing Address - Zip Code:99556-0414
Mailing Address - Country:US
Mailing Address - Phone:907-567-3419
Mailing Address - Fax:907-202-5169
Practice Address - Street 1:69423 SEITZ AVE
Practice Address - Street 2:HOME 2
Practice Address - City:NINILCHIK
Practice Address - State:AK
Practice Address - Zip Code:99639
Practice Address - Country:US
Practice Address - Phone:907-299-5670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAPPY VALLEY ASSISTED LIVING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-16
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK183630Medicaid
AK183635Medicaid