Provider Demographics
NPI:1619401072
Name:AARON ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:AARON ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-230-0358
Mailing Address - Street 1:PO BOX 210423
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99521-0423
Mailing Address - Country:US
Mailing Address - Phone:907-230-0358
Mailing Address - Fax:907-339-9188
Practice Address - Street 1:3800 GARDNER ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4964
Practice Address - Country:US
Practice Address - Phone:907-230-0358
Practice Address - Fax:907-339-9188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1050700253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHCXOtherHCBW STATE OF ALASKA