Provider Demographics
NPI:1568902666
Name:DIVINE HANDS ASSISTED LIVING HOME
Entity Type:Organization
Organization Name:DIVINE HANDS ASSISTED LIVING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAAMAKA
Authorized Official - Middle Name:FRANCESS
Authorized Official - Last Name:OGBECHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-884-6882
Mailing Address - Street 1:6236 SPRUCES MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507
Mailing Address - Country:US
Mailing Address - Phone:907-884-6882
Mailing Address - Fax:
Practice Address - Street 1:6236 SPRUCE MEADOWS DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-4715
Practice Address - Country:US
Practice Address - Phone:907-884-6882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101106253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care