Provider Demographics
NPI:1518598820
Name:ZACHERY JONES
Entity Type:Organization
Organization Name:ZACHERY JONES
Other - Org Name:JONES ALH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHERY
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-405-0193
Mailing Address - Street 1:1749 BRADWAY RD APT B
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-8307
Mailing Address - Country:US
Mailing Address - Phone:541-405-0193
Mailing Address - Fax:907-328-5969
Practice Address - Street 1:32 CRAIG AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3527
Practice Address - Country:US
Practice Address - Phone:541-405-0193
Practice Address - Fax:907-328-5969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility