Organization
GOOD GRACE ASSISTED LIVING HOME,LLC
Active
Organization
GOOD GRACE ASSISTED LIVING HOME,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIEELAINE TAYAN PENTECOSTES (OWNER/ ADMINISTRATOR)
(907) 929-0304
Entity
Organization
Contact information
Practice address
2649A CARROLL PL, ANCHORAGE, AK 99508-3821
(907) 929-0304
Mailing address
2649A CARROLL PL, ANCHORAGE, AK 99508-3821
(907) 929-0304
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
100904
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RLX
—
AK
Enumeration date
05/13/2011
Last updated
05/13/2011
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