Organization
SOURDOUGH'S HOUSING LLC
Active
Other names
Marlow Manor Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK OTOOLE (AGENT)
(503) 231-4922
Entity
Organization
Contact information
Practice address
2030 MULDOON RD, ANCHORAGE, AK 99504-3638
(907) 338-8708
(907) 338-8627
Mailing address
2030 MULDOON RD, ANCHORAGE, AK 99504-3638
(907) 338-8708
(907) 338-8627
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
101103
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RLX
—
AK
Enumeration date
06/09/2015
Last updated
06/09/2015
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