Organization
MAIN STREET ASSISTED LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH E BABCOCK (ADMINISTRATOR)
(907) 235-6149
Entity
Organization
Contact information
Practice address
4136 MAIN ST, HOMER, AK 99603-7035
(907) 235-6149
(907) 235-6149
Mailing address
4136 MAIN ST, HOMER, AK 99603-7035
(907) 235-6149
(907) 235-6149
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
00242
AK
343900000X
Non-emergency Medical Transport (VAN)
00242
AK
385H00000X
Respite Care
00242
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL8609
—
AK
Enumeration date
03/21/2007
Last updated
04/13/2010
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