Mountainside Assisted Living Home

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

101026 Issued in AK

Legal business name

MOUNTAINSIDE ASSISTED LIVING HOME

Practice address

633 5TH St
Douglas, AK 99824-5512

Phone

(907) 988-6422

NPI assigned

Jan 24, 2014

Last updated

Jan 10, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miah Lager

Title

Designee

Phone

(907) 635-6424

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420848000000",
    "number": "1184047292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 5TH ST",
            "city": "DOUGLAS",
            "state": "AK",
            "postal_code": "998245512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 5TH ST",
            "city": "DOUGLAS",
            "state": "AK",
            "postal_code": "998245512",
            "telephone_number": "907-988-6422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINSIDE ASSISTED LIVING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-24",
        "last_updated": "2015-01-10",
        "status": "A",
        "authorized_official_last_name": "LAGER",
        "authorized_official_first_name": "MIAH",
        "authorized_official_title_or_position": "DESIGNEE",
        "authorized_official_telephone_number": "907-635-6424"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "AK",
            "license": "101026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanne Alcantara
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• Andrea Kennedy Wilt Duncan
• Mary Doris Fitzgerald
• Cynthia Gordon Nickerson, RN CDE CMC
• Seak Care Solutions LLC
• Grace Ellen Urquhart, ARNP

• Developmentally Disabled Services Day Training Agency in Douglas, AK
• Providers in Douglas, AK by specialty
• Developmentally Disabled Services Day Training Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.