Provider Demographics
NPI:1982976395
Name:ANCHORED ABODE ASSISTED LIVING HOME, LLC.
Entity Type:Organization
Organization Name:ANCHORED ABODE ASSISTED LIVING HOME, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:STANTON
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CNMT, RT (N)
Authorized Official - Phone:907-727-0322
Mailing Address - Street 1:3909 TURNAGAIN BLVD E
Mailing Address - Street 2:SUITE # 1
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-2417
Mailing Address - Country:US
Mailing Address - Phone:907-733-4944
Mailing Address - Fax:907-334-6424
Practice Address - Street 1:3909 TURNAGAIN BLVD E
Practice Address - Street 2:SUITE # 1
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-2417
Practice Address - Country:US
Practice Address - Phone:907-733-4944
Practice Address - Fax:907-334-6424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1009363104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK100936OtherASSISTED LIVING HOME LICENSE