Provider Demographics
NPI:1205967676
Name:HIDDEN HEIGHTS ASSISTED LIVING, INC.
Entity type:Organization
Organization Name:HIDDEN HEIGHTS ASSISTED LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-242-9531
Mailing Address - Street 1:PO BOX 140924
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99514-0924
Mailing Address - Country:US
Mailing Address - Phone:907-242-9531
Mailing Address - Fax:907-677-8594
Practice Address - Street 1:3536 E 17TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3361
Practice Address - Country:US
Practice Address - Phone:907-278-6794
Practice Address - Fax:907-677-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK000155310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKRL8016OtherMCI