Organization
FAIRBANKS ASSISTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA MARGALEEN MHURIRO RN (OWNER)
(907) 888-5163
Entity
Organization
Contact information
Practice address
164 SYRACUSE CT APT 1, FAIRBANKS, AK 99709-2977
(907) 987-0304
Mailing address
114 CAHABA ST, ENTERPRISE, AL 36330-3627
(907) 888-5163
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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