Organization
ASPIRE ASSISTED LIVING HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WYNN PENTECOSTES RN (ADMINISTRATOR)
(907) 231-0188
Entity
Organization
Contact information
Practice address
8660 PIONEER DR, ANCHORAGE, AK 99504-4216
(907) 231-0188
Mailing address
4306 NEEDLE CIR, ANCHORAGE, AK 99508-5140
(907) 306-5671
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/02/2024
Last updated
05/02/2024
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