Provider Demographics
NPI:1205509700
Name:M-CARE ASSISTED LIVING HOME
Entity type:Organization
Organization Name:M-CARE ASSISTED LIVING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILOU
Authorized Official - Middle Name:G
Authorized Official - Last Name:PUGEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-331-7220
Mailing Address - Street 1:1023 E 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3939
Mailing Address - Country:US
Mailing Address - Phone:907-331-7220
Mailing Address - Fax:
Practice Address - Street 1:1023 E 28TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3939
Practice Address - Country:US
Practice Address - Phone:907-331-7220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities