Provider Demographics
NPI:1720290786
Name:TURNAGAIN FOSTER HOME
Entity Type:Organization
Organization Name:TURNAGAIN FOSTER HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MILAGROS
Authorized Official - Middle Name:VINA
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-868-1795
Mailing Address - Street 1:2812 WEST 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517
Mailing Address - Country:US
Mailing Address - Phone:907-243-4115
Mailing Address - Fax:907-868-1795
Practice Address - Street 1:2812 WEST 29TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517
Practice Address - Country:US
Practice Address - Phone:907-243-4115
Practice Address - Fax:907-868-1795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK0002983104A0630X
AK0000103104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK=========Medicaid