Organization
OUR LADY OF GUADALUPE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANALIZA Y PENTECOSTES (ADMINISTRATOR)
(907) 338-9588
Entity
Organization
Contact information
Practice address
8211 MAJESTIC DR, ANCHORAGE, AK 99504-4702
(907) 338-9588
(907) 644-7944
Mailing address
8211 MAJESTIC DR, ANCHORAGE, AK 99504-4702
(907) 338-9588
(907) 644-7944
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
HC# PENDING
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HC# PENDING
—
AK
Enumeration date
12/10/2007
Last updated
12/12/2007
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