Provider Demographics
NPI:1124315080
Name:CINDY AND VICS R & R, INC
Entity type:Organization
Organization Name:CINDY AND VICS R & R, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:CELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-244-8427
Mailing Address - Street 1:13337 STEPHENSON ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-4042
Mailing Address - Country:US
Mailing Address - Phone:907-230-3618
Mailing Address - Fax:907-891-0091
Practice Address - Street 1:929 E 81ST AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-3151
Practice Address - Country:US
Practice Address - Phone:907-230-3618
Practice Address - Fax:907-981-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK950597320600000X, 385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities