Provider Demographics
NPI:1457880064
Name:FRONTIER ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:FRONTIER ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:HANKERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-328-2200
Mailing Address - Street 1:1015 EVERGREEN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4306
Mailing Address - Country:US
Mailing Address - Phone:907-328-2200
Mailing Address - Fax:
Practice Address - Street 1:1015 EVERGREEN ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4306
Practice Address - Country:US
Practice Address - Phone:907-328-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101222310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility