Organization
SUNSET HAVEN ALH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELO MEDINA OCAMPO (DESIGNEE ADMINISTRATOR)
(907) 243-1169
Entity
Organization
Contact information
Practice address
4210 GALACTICA DR, ANCHORAGE, AK 99517-1444
(907) 243-1169
Mailing address
5950 KODY DR, ANCHORAGE, AK 99504-5307
(907) 337-1190
(907) 337-1190
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
434082
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL 6741
—
AK
Enumeration date
04/10/2007
Last updated
06/20/2008
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