Provider Demographics
NPI:1457135568
Name:ANGELS ABOVE ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:ANGELS ABOVE ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-992-4329
Mailing Address - Street 1:5581 SAPPHIRE LOOP
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-6000
Mailing Address - Country:US
Mailing Address - Phone:719-992-4329
Mailing Address - Fax:
Practice Address - Street 1:16415 MILLS PARK CIR
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-6718
Practice Address - Country:US
Practice Address - Phone:719-992-4329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility