Moose Shack Coffee
NPI #1699962415 in Eagle River, Alaska
Provider Information
- NPI Number
- 1699962415
- Entity Type
- Organization
- Organization Name
- Moose Shack Coffee
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Sep 25, 2007
- Last Updated
- Sep 19, 2014
Practice Location
- Address
- 19216 CITATION RD
- City
- Eagle River
- State
- Alaska
- ZIP Code
- 99577-8416
- Phone
- (907) 351-0569
Authorized Official
- Name
- MS. CANDIS DENISE BISHOP
- Title
- OWNER
- Phone
- (907) 351-0569
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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