Provider Demographics
NPI:1417483645
Name:PEACE AND HARMONY ALH
Entity Type:Organization
Organization Name:PEACE AND HARMONY ALH
Other - Org Name:PEACE AND HARMONY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:DENNISE
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-310-6434
Mailing Address - Street 1:107 MATTHEW PAUL WAY
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-4888
Mailing Address - Country:US
Mailing Address - Phone:907-310-6434
Mailing Address - Fax:907-337-2337
Practice Address - Street 1:107 MATTHEW PAUL WAY
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-4888
Practice Address - Country:US
Practice Address - Phone:907-310-6434
Practice Address - Fax:907-337-2337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-09
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100909310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1601182Medicaid
AK1636011Medicaid