Provider Demographics
NPI:1710468624
Name:FULANI ALH
Entity Type:Organization
Organization Name:FULANI ALH
Other - Org Name:FULANI ALH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOMODOU
Authorized Official - Middle Name:
Authorized Official - Last Name:JALLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-205-0394
Mailing Address - Street 1:2591 LYVONA LN
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-5452
Mailing Address - Country:US
Mailing Address - Phone:190-720-5039
Mailing Address - Fax:
Practice Address - Street 1:2591 LYVONA LN
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-5452
Practice Address - Country:US
Practice Address - Phone:190-720-5039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100880311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility