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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