Provider Demographics
NPI:1811334667
Name:CAREL ASSISTED LIVING HOME LLC
Entity type:Organization
Organization Name:CAREL ASSISTED LIVING HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAPHNE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAVANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-952-0830
Mailing Address - Street 1:5058 BRYN MAWR CT
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4722
Mailing Address - Country:US
Mailing Address - Phone:907-677-2645
Mailing Address - Fax:907-677-2546
Practice Address - Street 1:5058 BRYN MAWR COURT
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-677-2645
Practice Address - Fax:907-677-2546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-03
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100730310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility