Provider Demographics
NPI:1356563860
Name:SYLVIA GERAGHTY
Entity type:Organization
Organization Name:SYLVIA GERAGHTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GERAGHTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-874-3165
Mailing Address - Street 1:PO BOX 1861
Mailing Address - Street 2:306 CASSIAR STREET
Mailing Address - City:WRANGELL
Mailing Address - State:AK
Mailing Address - Zip Code:99929-1861
Mailing Address - Country:US
Mailing Address - Phone:907-874-3165
Mailing Address - Fax:
Practice Address - Street 1:306 CASSIAR ST.
Practice Address - Street 2:
Practice Address - City:WRANGELL
Practice Address - State:AK
Practice Address - Zip Code:99929-1861
Practice Address - Country:US
Practice Address - Phone:907-874-3165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKRL8258310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility