Provider Demographics
NPI:1477881738
Name:UNANGAM SISMIILUGAA
Entity Type:Organization
Organization Name:UNANGAM SISMIILUGAA
Other - Org Name:JOANIE'S PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DIMITRI
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILEMONOF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-276-2700
Mailing Address - Street 1:1131 E INTERNATIONAL AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-1408
Mailing Address - Country:US
Mailing Address - Phone:907-276-2700
Mailing Address - Fax:907-222-4276
Practice Address - Street 1:6819 ROVENNA ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-2169
Practice Address - Country:US
Practice Address - Phone:907-646-1412
Practice Address - Fax:907-646-8012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100799310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility