Organization
DIVINE MERCY ALH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIEZER PENTECOSTES (ADMINISTRATOR)
(907) 868-8608
Entity
Organization
Contact information
Practice address
8100 PECK AVE, ANCHORAGE, AK 99504-1422
(907) 868-8608
(907) 868-8608
Mailing address
8100 PECK AVE, ANCHORAGE, AK 99504-1422
(907) 868-8608
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
100397
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL2598
—
AK
Enumeration date
04/10/2007
Last updated
06/16/2008
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