Abby Assisted Living LLC – Custodial Care Facility

Key facts

NPI: 1093476947
Entity type: Organization (NPI type 2)
Primary specialty: Custodial Care Facility 311Z00000X
Legal business name: ABBY ASSISTED LIVING LLC
Practice address: 1781 S Abby Blvd
Wasilla, AK 99654-8448
Phone: (907) 306-4173
NPI assigned: Jan 4, 2022
Organization subpart: No

Authorized official

Name: Jessica Fulton
Title: Owner
Phone: (907) 306-4173

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Jessica Tiara Fulton Assisted Living Facility (Mental Illness) · Anchorage, AK · NPI 1629585229

NPD

National Provider Directory

Interoperability endpoints

Direct secure messaging: admin@oal.directak.net

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Custodial Care Facility	311Z00000X			Yes

Addresses

Primary practice location

1781 S Abby Blvd
Wasilla, AK 99654-8448

Mailing address

400 W 76TH Ave Apt 105
Anchorage, AK 99518-2551

Other identifiers

Identifier	Type	State	Issuer
1681005	Medicaid	AK
1724270	Medicaid	AK

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	admin@oal.directak.net	Direct	MISTY GLEN ASSISTED LIVING LLC
Direct Messaging Address	admin@oal.directak.net	Direct	Orchard Assisted Living

Other providers in Wasilla, AK

All providers in Wasilla, AK · Custodial Care Facility in Alaska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.