IndividualActive
Mam Jallow
NPI 1225368335 · Physical Disabilities Residential Treatment Facility · Anchorage, AK
Provider details
- NPI number
- 1225368335
- Entity type
- Individual
- Primary specialty
- Physical Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 938082 (AK)
Specialties & taxonomies
Residential Treatment Facilities
- Intellectual and/or Developmental Disabilities Residential Treatment Facility320600000XLicense 938082 (AK)
Residential Treatment Facilities
Practice location
1493 Moss Creek Ave
Anchorage, AK 99507-3800
Phone: (907) 929-5620
Approximate (ZIP-level) locationGet directions
Mailing address
1010 W 29th Pl
Anchorage, AK 99503-3744
Registry dates
- Enumerated
- 2010-01-12
- Last updated
- 2018-02-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.