Provider Demographics
NPI:1013793421
Name:2 CARE ASSISTED LIVING HOME
Entity Type:Organization
Organization Name:2 CARE ASSISTED LIVING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR /OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SERING
Authorized Official - Middle Name:
Authorized Official - Last Name:JANFO PHATTEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-350-6031
Mailing Address - Street 1:432 N LANE ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-1710
Mailing Address - Country:US
Mailing Address - Phone:907-350-6071
Mailing Address - Fax:
Practice Address - Street 1:432 N LANE ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-1710
Practice Address - Country:US
Practice Address - Phone:907-350-6071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty