Organization
DIVINE MERCY ALH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIEZER PENTECOSTES (ADMINISTRATOR)
(907) 868-8608
Entity
Organization
Contact information
Practice address
3554 NEWCOMB DR, ANCHORAGE, AK 99508-4852
(907) 868-8608
(907) 868-8608
Mailing address
3554 NEWCOMB DR, ANCHORAGE, AK 99508-4852
(907) 868-8608
(907) 868-8608
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
100397
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HC2598
—
AK
Enumeration date
04/04/2007
Last updated
09/23/2011
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