Organization
SIMPLY BLUE,ALH,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA VALLANGCA RN (ADMINISTRATIVE OFFICER)
(203) 822-1055
Entity
Organization
Contact information
Practice address
7451 TYONE CT, ANCHORAGE, AK 99504-3531
(907) 570-6699
(907) 929-1178
Mailing address
7451 TYONE CT, ANCHORAGE, AK 99504-3531
(907) 570-6699
(907) 929-1178
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10029349
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RLX
DHSS, HOME AND BASE WAIVER PROGRAM PROVIDER CERTIFICATION
AK
Enumeration date
06/02/2016
Last updated
06/02/2016
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