Provider Demographics
NPI:1700909116
Name:MARLOW MANOR DOWNTOWN LLC
Entity Type:Organization
Organization Name:MARLOW MANOR DOWNTOWN LLC
Other - Org Name:MARLOW MANOR DOWNTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:C
Authorized Official - Last Name:O'TOOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-231-4922
Mailing Address - Street 1:337 E 4TH AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501
Mailing Address - Country:US
Mailing Address - Phone:907-279-0161
Mailing Address - Fax:907-279-0164
Practice Address - Street 1:337 E 4TH AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501
Practice Address - Country:US
Practice Address - Phone:907-279-0161
Practice Address - Fax:907-279-0164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100580310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility