Provider Demographics
NPI:1083760433
Name:GENTLE CARE SERVICES INC.
Entity Type:Organization
Organization Name:GENTLE CARE SERVICES INC.
Other - Org Name:GENACTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NGOZI
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:ISOLOKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-884-0906
Mailing Address - Street 1:PO BOX 210672
Mailing Address - Street 2:PO BOX 210672
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99521-0672
Mailing Address - Country:US
Mailing Address - Phone:907-644-7952
Mailing Address - Fax:
Practice Address - Street 1:2217 E TUDOR RD STE 11
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1074
Practice Address - Country:US
Practice Address - Phone:907-644-7952
Practice Address - Fax:907-644-7953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKHC6161-DSDS CERT.251G00000X
AKPCG6161-DSDS CERT.251T00000X
253Z00000X, 261QM1300X, 291U00000X
AK100558320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251G00000XAgenciesHospice Care, Community Based
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No291U00000XLaboratoriesClinical Medical Laboratory
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKPCG6161Medicaid
AKHC6161Medicaid
AKRL6161Medicaid