Provider Demographics
NPI:1992040091
Name:UR PRECIOUS ASSISTED LIVING HOME,LLC
Entity Type:Organization
Organization Name:UR PRECIOUS ASSISTED LIVING HOME,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:P
Authorized Official - Last Name:JUAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-770-6268
Mailing Address - Street 1:1925 COLONY PL
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-5395
Mailing Address - Country:US
Mailing Address - Phone:907-770-6268
Mailing Address - Fax:907-770-1722
Practice Address - Street 1:1925 COLONY PL
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-5395
Practice Address - Country:US
Practice Address - Phone:907-770-6268
Practice Address - Fax:907-770-1722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1009383104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness