Provider Demographics
NPI:1932311420
Name:BLESSED HOME, LLC
Entity Type:Organization
Organization Name:BLESSED HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:I
Authorized Official - Last Name:ASTOJI
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:907-529-1518
Mailing Address - Street 1:9330 APHRODITE DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1493
Mailing Address - Country:US
Mailing Address - Phone:907-529-1518
Mailing Address - Fax:
Practice Address - Street 1:9330 APHRODITE DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1493
Practice Address - Country:US
Practice Address - Phone:907-529-1518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK433151310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKRL3373Medicaid