National Provider Identifier Database

QUEEN ANNE AVENUE LLC
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

QUEEN ANNE AVENUE LLC
6816 W QUEEN ANNE AVE
HOUSE #1
WASILLA, AK99654
Phone: 907-318-2180
Fax: 866-336-7276
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for QUEEN ANNE AVENUE LLC

NPI Number 1477403509
Legal business name
LBN
QUEEN ANNE AVENUE LLC
Authorized official ROSS MORTON - (CEO)
Entity Organization
Organization subpart No
Enumeration date 01/29/2026
Last updated 04/18/2026 - About 2 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for QUEEN ANNE AVENUE LLC

There are currently no reviews for QUEEN ANNE AVENUE LLC


NPIdb - Home
v2.201