Provider Demographics
NPI:1710518303
Name:ALASKA DAY HABILITATION SERVICES LLC
Entity Type:Organization
Organization Name:ALASKA DAY HABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEMILYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAYAVONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-885-8420
Mailing Address - Street 1:PO BOX 231741
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99523-1741
Mailing Address - Country:US
Mailing Address - Phone:907-885-8420
Mailing Address - Fax:
Practice Address - Street 1:4121 CRANNOG ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-5174
Practice Address - Country:US
Practice Address - Phone:907-885-8420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-01
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services