Provider Demographics
NPI:1093838948
Name:APHRODITE ASSISTED LIVING HOME INC
Entity Type:Organization
Organization Name:APHRODITE ASSISTED LIVING HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-230-8486
Mailing Address - Street 1:PO BOX 92393
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99509-2393
Mailing Address - Country:US
Mailing Address - Phone:907-346-2809
Mailing Address - Fax:907-868-1599
Practice Address - Street 1:9230 APHRODITE DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1498
Practice Address - Country:US
Practice Address - Phone:907-346-2809
Practice Address - Fax:907-868-1599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKRL16451Medicaid