Provider Demographics
NPI:1336023415
Name:KLAUKA, DANIEL ROBERT
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:ROBERT
Last Name:KLAUKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 N BLUEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654
Mailing Address - Country:US
Mailing Address - Phone:907-671-8121
Mailing Address - Fax:
Practice Address - Street 1:1951 N BLUEBERRY DR
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654
Practice Address - Country:US
Practice Address - Phone:907-671-8121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-02
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2209554315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities