Provider Demographics
NPI:1932663820
Name:3 ANGELS' ASSISTED LIVING HOME LLC
Entity Type:Organization
Organization Name:3 ANGELS' ASSISTED LIVING HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHONA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-350-9715
Mailing Address - Street 1:2937 MORGAN LOOP
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-1427
Mailing Address - Country:US
Mailing Address - Phone:907-350-9715
Mailing Address - Fax:
Practice Address - Street 1:1302 GARDEN ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2937
Practice Address - Country:US
Practice Address - Phone:907-350-9715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility