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VIRGINIA N WODKOWSKI

>> Assisted Living Facility >> Nursing & Custodial Care Facilities

Registrant NPI Number: 1770606030

Individual Registrant:
 VIRGINIA N WODKOWSKI 
Gender: F
Sole Proprietor

Location and contact information for practice:
24572 W LUCKY SHOT TRAIL  WILLOW, AK 99688 US
Tel: 907-495-6842  Fax: --

Contact information for business:
PO BOX 557  WILLOW, AK 99688-0557 US
Tel: 907-495-6842  Fax: --

Registration Information:
NPI: 1770606030
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
X310400000XNursing & Custodial Care Facilities
Assisted Living Facility
AKRL2570
X311Z00000XNursing & Custodial Care Facilities
Custodial Care Facility
AKRL2570

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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