Moose Shack Coffee

Assisted Living Facility · Eagle River, AK

Organization Active NPI

NPI number 1699962415

Practice location

19216 Citation Rd
Eagle River, AK 99577-8416
Phone
(907) 351-0569

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NPI record

NPI
1699962415
Entity type
Organization (Type 2)
Enumeration date
September 25, 2007
Last updated
September 19, 2014
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Assisted Living Facility Primary 310400000X 101077 AK

Mailing address

7531 Randamar Pl
Anchorage, AK 99507-5718
Phone
(907) 351-0569

Authorized official

Name
Ms. Candis Denise Bishop
Title
Owner
Phone
(907) 351-0569

Other names

  • Autumn Sunrise

About Moose Shack Coffee

Moose Shack Coffee is a healthcare organization registered in the NPI registry with the primary taxonomy Assisted Living Facility (code 310400000X). The practice location is 19216 Citation Rd, Eagle River, AK 99577-8416. The NPI number 1699962415 was assigned on September 25, 2007 and the record was last updated on September 19, 2014.

Moose Shack Coffee lists a license in the registry: #101077 (AK) for Assisted Living Facility. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Ms. Candis Denise Bishop, Owner.

Frequently asked questions

What is the NPI number of Moose Shack Coffee?

The NPI number is 1699962415.

What is the phone number of Moose Shack Coffee?

The phone number listed for the practice location is (907) 351-0569.

Where is Moose Shack Coffee located?

19216 Citation Rd, Eagle River, AK 99577-8416.

What is the taxonomy code for Moose Shack Coffee?

The primary taxonomy code is 310400000X – Assisted Living Facility.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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