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Organization

QUEEN OF HEARTS ASSISTED LIVING HOME LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
QUEENIE CAYABYAB (OWNER/ADMINISTRATOR)
(907) 342-5937
Entity
Organization

Contact information

Practice address
3300 E 15TH AVE, ANCHORAGE, AK 99508-3005
(907) 342-5937
(907) 929-0492
Mailing address
6821 QUEENS VIEW CIR, ANCHORAGE, AK 99504-5203
(907) 342-5937

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
101057
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101057
ASSISTED LIVING HOME LICENSE
AK
05
1613952
AK
01
998397
BUSINESS LICENSE
AK
Enumeration date
05/29/2014
Last updated
04/29/2022
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