Provider Demographics
NPI:1205965142
Name:ASSISTEDCARE SERVICES, LLC
Entity type:Organization
Organization Name:ASSISTEDCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLAIDE
Authorized Official - Middle Name:TEMITOPE
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:907-929-2828
Mailing Address - Street 1:PO BOX 221876
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99522-1876
Mailing Address - Country:US
Mailing Address - Phone:907-929-2828
Mailing Address - Fax:907-929-5858
Practice Address - Street 1:405 E FIREWEED LN
Practice Address - Street 2:SUITE 202
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2111
Practice Address - Country:US
Practice Address - Phone:907-929-2828
Practice Address - Fax:907-929-5858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKPCG679Medicaid