Provider Demographics
NPI:1063689693
Name:CARIDAD HOME CARE, INC.
Entity Type:Organization
Organization Name:CARIDAD HOME CARE, INC.
Other - Org Name:CARIDAD HOME HEALTH, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-563-0104
Mailing Address - Street 1:PO BOX 244335
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99524-4335
Mailing Address - Country:US
Mailing Address - Phone:907-274-0038
Mailing Address - Fax:907-222-0511
Practice Address - Street 1:401 W INTERNATIONAL AIRPORT RD
Practice Address - Street 2:SUITE 15
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1116
Practice Address - Country:US
Practice Address - Phone:907-274-0038
Practice Address - Fax:907-222-0511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK718409251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHC4642Medicaid
AKPCG696Medicaid
AKCMG538Medicaid
AKPCG6961Medicaid