Provider Demographics
NPI:1962657940
Name:LAURA L. OWENS
Entity Type:Organization
Organization Name:LAURA L. OWENS
Other - Org Name:THE ARK OF HOMER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-235-7942
Mailing Address - Street 1:1136 SEABREEZE CT
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7935
Mailing Address - Country:US
Mailing Address - Phone:907-235-7942
Mailing Address - Fax:
Practice Address - Street 1:1136 SEABREEZE CT
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7935
Practice Address - Country:US
Practice Address - Phone:907-235-7942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100717310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility