Organization
SAINT TIMOTHY HOME 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IRENE CERVAS ESCALANTE (OWNER/ADMINISTRATOR)
(907) 337-6364
Entity
Organization
Contact information
Practice address
12363 DIVISION ST, ANCHORAGE, AK 99515-3436
(907) 337-6364
(907) 338-6365
Mailing address
12363 DIVISION ST, ANCHORAGE, AK 99515-3436
(907) 337-6364
(907) 338-6365
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
100271
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL 49331
—
AK
05
—
RL 49332
—
AK
Enumeration date
01/22/2008
Last updated
01/22/2008
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