Provider Demographics
NPI:1689816548
Name:PIONEER EXTENED CARE CENTER
Entity Type:Organization
Organization Name:PIONEER EXTENED CARE CENTER
Other - Org Name:FAMILY INK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-250-6758
Mailing Address - Street 1:PO BOX 220553
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99522-0553
Mailing Address - Country:US
Mailing Address - Phone:907-250-6758
Mailing Address - Fax:907-563-0994
Practice Address - Street 1:4211 COPE STREET
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-260-6758
Practice Address - Fax:907-563-0994
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY INK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility