Provider Demographics
NPI:1922170851
Name:5-D CORPORATION
Entity Type:Organization
Organization Name:5-D CORPORATION
Other - Org Name:NORTHERN COMFORT ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MERRI
Authorized Official - Middle Name:BELLE
Authorized Official - Last Name:DIAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:907-746-6493
Mailing Address - Street 1:4300 N TRUNK RD
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645
Mailing Address - Country:US
Mailing Address - Phone:907-746-6493
Mailing Address - Fax:907-746-6499
Practice Address - Street 1:2800 N LAGOON DR.
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654
Practice Address - Country:US
Practice Address - Phone:907-746-6493
Practice Address - Fax:907-746-6499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK241310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility