Provider Demographics
NPI:1770923021
Name:ST. FRANCIS ALH
Entity type:Organization
Organization Name:ST. FRANCIS ALH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHYSICAL THERAPY
Authorized Official - Phone:907-929-1499
Mailing Address - Street 1:120 ACES CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1175
Mailing Address - Country:US
Mailing Address - Phone:907-929-1499
Mailing Address - Fax:907-929-1178
Practice Address - Street 1:120 ACES CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1175
Practice Address - Country:US
Practice Address - Phone:907-929-1499
Practice Address - Fax:907-929-1178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100974310400000X
AK000221310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKRL9705Medicaid
AKRLXMedicaid
AKHC9705Medicaid
AKRL 9705 AND HC9705Medicaid