Provider Demographics
NPI:1760902803
Name:DISCOVERY LIVING LLC
Entity Type:Organization
Organization Name:DISCOVERY LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TERAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-440-7259
Mailing Address - Street 1:17420 CHARITY LN
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7004
Mailing Address - Country:US
Mailing Address - Phone:907-440-7259
Mailing Address - Fax:907-694-2595
Practice Address - Street 1:16845 ELEONORA ST
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7614
Practice Address - Country:US
Practice Address - Phone:907-440-7259
Practice Address - Fax:907-440-7259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services