QUEEN ANNE AVENUE LLC – NPI #1477403509
Substance Abuse 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.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

QUEEN ANNE AVENUE LLC is a substance abuse rehabilitation facility located in WASILLA, AK. NPPES has assigned the NPI number 1477403509 to QUEEN ANNE AVENUE LLC on January 29, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

The NPI profile was last updated on Apr 18, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for QUEEN ANNE AVENUE LLC below.

NPI Profile for
QUEEN ANNE AVENUE LLC

NPI Number
1477403509
Enumeration Date

(about 4 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
QUEEN ANNE AVENUE LLC
Primary location
6816 W QUEEN ANNE AVE
HOUSE #1
WASILLA, AK 99654
Phone: (907) 318-2180 Fax: (866) 336-7276
Mailing address
1741 E ROSEVILLE PKWY STE 100
ROSEVILLE, CA 95661-6450
Phone: (916) 784-1149 Fax: (866) 336-7276
Organization Subpart
No
Authorized Official
ROSS MORTON
CEO
Phone: (916) 847-4006
Updated
Certification Date
Apr 18, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.