Provider Demographics
NPI:1558980706
Name:GENTLE HANDS CARE ASSISTED LIVING HOME LLC
Entity Type:Organization
Organization Name:GENTLE HANDS CARE ASSISTED LIVING HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ARELEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-315-2755
Mailing Address - Street 1:PO BOX 141296
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99514-1296
Mailing Address - Country:US
Mailing Address - Phone:907-201-1985
Mailing Address - Fax:
Practice Address - Street 1:4092 W MARBLE WAY
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-8752
Practice Address - Country:US
Practice Address - Phone:907-201-1985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK99A6GL0000495-00OtherBARRETT & ASSOCIATES, LLC
VAMWC0156385-01OtherMARKEL AMERICAN INSURANCE COMP