Provider Demographics
NPI:1558687087
Name:CARITAS ASSISTED LIVING HOME INC.
Entity Type:Organization
Organization Name:CARITAS ASSISTED LIVING HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRES/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:LADORES
Authorized Official - Last Name:LUBATON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-929-4819
Mailing Address - Street 1:1720 ADONIS DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515
Mailing Address - Country:US
Mailing Address - Phone:907-929-4819
Mailing Address - Fax:907-929-3819
Practice Address - Street 1:1720 ADONIS DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1486
Practice Address - Country:US
Practice Address - Phone:907-929-4819
Practice Address - Fax:907-929-3819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKRL7356310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility