Organization
JEWEL LAKE ASSISTED LIVING HOME LLC
Active
Organization
JEWEL LAKE ASSISTED LIVING HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARTHUR REYES BONGLO REGISTERED NURSE (ADMINISTRATOR)
(907) 243-9570
Entity
Organization
Contact information
Practice address
4132 W 88TH AVE, ANCHORAGE, AK 99502-5107
(907) 243-9570
(907) 245-0035
Mailing address
4132 WEST 88TH AVE., ANCHORAGE, AK 99502
(907) 243-9570
(907) 245-0035
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
101014
AK
Other
Enumeration date
11/15/2013
Last updated
11/15/2013
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