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Alice Shantz
Lodging Provider in Bethel, Alaska
NPI 1013137348

Alice Shantz is a Lodging Provider based in Bethel, AK. Alice Shantz practices in Bethel, AK. The NPI Number for Alice Shantz is 1013137348 and holds a License No. 432920 (Alaska).

The current practice location address for Alice Shantz is 473 Ridgecrest Drive, Bethel, AK and can be reached out via phone at 907-543-3232 and via fax at 907-543-1443.

Location: 473 Ridgecrest Drive, Bethel, AK, 99559-1915
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1013137348
Provider Name
Alice Shantz
Credential
Provider Entity Type
Organization
Address
473 Ridgecrest Drive, Bethel, AK, 99559-1915
Phone Number
907-543-3232
Fax Number
907-543-1443
Provider Enumeration Date
04/27/2007
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
HM3180 05 AK
institution
Provider Business Practice Location Address Details
Address
473 Ridgecrest Drive
City
Bethel
State
Alaska
Zip
99559-1915
Phone Number
907-543-3232
Fax Number
907-543-1443
person
Provider Business Mailing Address Details
Address
473 Ridgecrest Drive
City
Bethel
State
Alaska
Zip
99559-1915
Phone Number
907-543-3232
Fax Number
907-543-1443
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Lodging
Speciality
-
Taxonomy
177F00000X
License No.
432920 (Alaska)
Definition
A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home.
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