Provider Demographics
NPI:1093843344
Name:FINE PEARLE LLC
Entity Type:Organization
Organization Name:FINE PEARLE LLC
Other - Org Name:FINE PEARLE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PERLITA
Authorized Official - Middle Name:ESPIRITU
Authorized Official - Last Name:AYSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:907-644-9079
Mailing Address - Street 1:1725 MINERVA WAY
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1490
Mailing Address - Country:US
Mailing Address - Phone:907-644-9079
Mailing Address - Fax:
Practice Address - Street 1:1725 MINERVA WAY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1490
Practice Address - Country:US
Practice Address - Phone:907-644-9079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100463310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility