Provider Demographics
NPI:1083737357
Name:SACRED HEART CARE CENTER
Entity Type:Organization
Organization Name:SACRED HEART CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:907-561-6542
Mailing Address - Street 1:8232 BLACKBERRY ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-4362
Mailing Address - Country:US
Mailing Address - Phone:907-561-6542
Mailing Address - Fax:907-677-0471
Practice Address - Street 1:8232 BLACKBERRY ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-4362
Practice Address - Country:US
Practice Address - Phone:907-561-6542
Practice Address - Fax:907-677-0471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK000172310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility