Provider Demographics
NPI:1609220797
Name:HOWARD HOUSE LLC
Entity Type:Organization
Organization Name:HOWARD HOUSE LLC
Other - Org Name:CREEKSIDE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE-HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-229-5083
Mailing Address - Street 1:3220 AMBER BAY CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-2323
Mailing Address - Country:US
Mailing Address - Phone:907-229-5083
Mailing Address - Fax:907-334-1960
Practice Address - Street 1:7710 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1916
Practice Address - Country:US
Practice Address - Phone:907-333-4454
Practice Address - Fax:907-334-1960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-15
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101210310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility