Provider Demographics
NPI:1790499804
Name:CELESTIAL CARE ALH LLC
Entity Type:Organization
Organization Name:CELESTIAL CARE ALH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEISSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GADIANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-331-8730
Mailing Address - Street 1:2295 JASPER LN
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-6004
Mailing Address - Country:US
Mailing Address - Phone:907-331-8730
Mailing Address - Fax:
Practice Address - Street 1:2295 JASPER LN
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-6004
Practice Address - Country:US
Practice Address - Phone:907-331-8730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty