Provider Demographics
NPI:1932469848
Name:ST. PAUL HOME CARE SERVICES
Entity Type:Organization
Organization Name:ST. PAUL HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:DALAODAO
Authorized Official - Last Name:ERIBAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-929-7591
Mailing Address - Street 1:3505 E 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3368
Mailing Address - Country:US
Mailing Address - Phone:907-929-7591
Mailing Address - Fax:907-929-7316
Practice Address - Street 1:3505 E 18TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3368
Practice Address - Country:US
Practice Address - Phone:907-929-7591
Practice Address - Fax:907-929-7316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100929310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility