Provider Demographics
NPI:1366865859
Name:INFINITE CARE OF ALASKA LLC
Entity Type:Organization
Organization Name:INFINITE CARE OF ALASKA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BULAONG
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, MBA
Authorized Official - Phone:907-646-0888
Mailing Address - Street 1:PO BOX 110154
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99511-0154
Mailing Address - Country:US
Mailing Address - Phone:907-646-0888
Mailing Address - Fax:907-646-1088
Practice Address - Street 1:1225 E INTERNATIONAL AIRPORT RD STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1410
Practice Address - Country:US
Practice Address - Phone:907-646-0888
Practice Address - Fax:907-646-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health