Organization
CARMELITE HOME
Active
Other names
Carmelite Home
Organization subpart
No
Provider details
NPI number
Authorized official
AINA R FOWLER (ADMINISTRATOR/OWNER)
(907) 336-1296
Entity
Organization
Contact information
Practice address
9401 APHRODITE DR., ANCHORAGE, AK 99515
(907) 336-1296
(907) 336-1298
Mailing address
9401 APHRODITE DR., ANCHORAGE, AK 99515
(907) 336-1296
(907) 336-1298
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
100955
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RLX
HOME AND COMMUNITY BASED WAIVER PROGRAM
AK
Enumeration date
09/13/2012
Last updated
09/13/2012
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