Provider Demographics
NPI:1396907507
Name:ANCHOR' CARE ASSISTED LIVING HOME
Entity type:Organization
Organization Name:ANCHOR' CARE ASSISTED LIVING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:H
Authorized Official - Last Name:ANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-332-0514
Mailing Address - Street 1:5225 E 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3705
Mailing Address - Country:US
Mailing Address - Phone:907-332-0514
Mailing Address - Fax:907-332-0514
Practice Address - Street 1:5225 E 22ND AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3705
Practice Address - Country:US
Practice Address - Phone:907-332-0514
Practice Address - Fax:907-332-0514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-28
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100672310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK100672OtherASSISTED LIVING HOME LICENSE
AK908091OtherAK BUSINESS LICENSE