Organization
SERENE GRACE ASSISTED LIVING HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MIRASOL WILLIAMS (SOLE MEMBER)
(907) 272-4073
Entity
Organization
Contact information
Practice address
3639 E 74TH AVE, ANCHORAGE, AK 99507-2829
(907) 272-4073
(907) 522-1626
Mailing address
3639 E 74TH AVE, ANCHORAGE, AK 99507-2829
(907) 272-4073
(907) 522-1626
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
101199
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101199
STATE OF ALASKA
AK
01
—
1051694
STATE OF ALASKA
AK
Enumeration date
10/18/2017
Last updated
06/16/2018
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