Provider Demographics
NPI:1164128831
Name:CARE FOR LIFE INC DBA COMFORT CARE HOME
Entity Type:Organization
Organization Name:CARE FOR LIFE INC DBA COMFORT CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:J
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-830-3772
Mailing Address - Street 1:7390 WINCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2856
Mailing Address - Country:US
Mailing Address - Phone:907-830-3772
Mailing Address - Fax:907-332-1414
Practice Address - Street 1:7390 WINCHESTER ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2856
Practice Address - Country:US
Practice Address - Phone:907-830-3772
Practice Address - Fax:907-332-1414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE FOR LIFE INC DBA COMFORT CARE HOME II
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK101529Medicaid
AK101528Medicaid