Alaska Life Group Home, LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

Legal business name

ALASKA LIFE GROUP HOME, LLC

Practice address

23812 Dolly Ave
Chugiak, AK 99567-5577

Phone

(907) 854-0443

NPI assigned

Jan 21, 2025

Organization subpart

No

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

Authorized official

Name

Holly Cannon

Title

Administrator

Phone

(907) 854-0443

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1184436883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670590",
            "city": "CHUGIAK",
            "state": "AK",
            "postal_code": "995670590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23812 DOLLY AVE",
            "city": "CHUGIAK",
            "state": "AK",
            "postal_code": "995675577",
            "telephone_number": "907-854-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALASKA LIFE GROUP HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-854-0443"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Chugiak, AK
• Respite Care in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.