Provider Demographics
NPI:1376935353
Name:ANNES HOME CARE
Entity Type:Organization
Organization Name:ANNES HOME CARE
Other - Org Name:LIBERTY M GUINTO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIBERTY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUINTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-230-3132
Mailing Address - Street 1:3971 DEFIANCE ST.,
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:ALASKA
Mailing Address - Zip Code:99504
Mailing Address - Country:UM
Mailing Address - Phone:907-230-3132
Mailing Address - Fax:
Practice Address - Street 1:3971 DEFIANCE ST.,
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:ALASKA
Practice Address - Zip Code:99504
Practice Address - Country:UM
Practice Address - Phone:907-230-3132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1134518772320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities