Provider Demographics
NPI:1952587552
Name:LIVING STONE HOME CARE, LLC
Entity Type:Organization
Organization Name:LIVING STONE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAVIS
Authorized Official - Middle Name:AGHAYEMA
Authorized Official - Last Name:SLONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-230-2402
Mailing Address - Street 1:5500 ALORA LOOP
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1047
Mailing Address - Country:US
Mailing Address - Phone:907-230-2402
Mailing Address - Fax:907-334-6405
Practice Address - Street 1:3500/3502 SKIPPER ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504
Practice Address - Country:US
Practice Address - Phone:907-334-9213
Practice Address - Fax:907-334-6405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100516310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility