Provider Demographics
NPI:1437378957
Name:AGAPE ASSISTED LIVING HOMES
Entity Type:Organization
Organization Name:AGAPE ASSISTED LIVING HOMES
Other - Org Name:AGAPE ASSISTED LIVING HOME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:ISABEL
Authorized Official - Last Name:KELLERMAN-DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-868-1289
Mailing Address - Street 1:PO BOX 231001
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99523-1001
Mailing Address - Country:US
Mailing Address - Phone:907-868-1289
Mailing Address - Fax:907-243-6814
Practice Address - Street 1:3741 AMBER BAY LOOP
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-2356
Practice Address - Country:US
Practice Address - Phone:907-929-3199
Practice Address - Fax:907-243-6814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility