Organization
GRACEFUL LIVING LLC
Active
Parent organization
GRACEFUL LIVING LLC
Other names
same
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRACEFUL LIVING LLC
Authorized official
CHRISTIANA ILUSEN ULOFOSHIO LPN (OWNER/ADMINISTRATOR)
(907) 929-2431
Entity
Organization
Contact information
Practice address
6300 E 9TH AVE, ANCHORAGE, AK 99504-1720
(907) 929-2431
(907) 338-3012
Mailing address
6300 E 9TH AVE, ANCHORAGE, AK 99504-1720
(907) 929-2431
(907) 338-3012
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
HC3704
AK
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
HC37041
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548461445
—
AK
Enumeration date
05/22/2009
Last updated
05/22/2009
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