Organization
DIVINE MERCY II ALH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIEZER LIMUN PENTECOSTES (OWNER/ADMINISTRATOR)
(907) 868-8608
Entity
Organization
Contact information
Practice address
417 E 11TH AVE APT 5, ANCHORAGE, AK 99501-4560
(907) 770-9148
(907) 770-9149
Mailing address
3554 NEWCOMB DRIVE, ANCHORAGE, AK 99508-4852
(907) 868-8608
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
100892
AK
385H00000X
Respite Care
100892
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528358207
—
AK
Enumeration date
04/14/2011
Last updated
09/23/2011
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