Organization
IMMACULATED CONCEPCION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JEANEPHERE HILARIO LORENZANA (ADMINISTRATOR)
(907) 332-0158
Entity
Organization
Contact information
Practice address
1836 LAURA CIRCLE, ANCHORAGE, AK 99508-3516
(907) 332-0158
(907) 332-0958
Mailing address
1836 LAURA CIRCLE, ANCHORAGE, AK 99508-3516
(907) 332-0158
(907) 332-0958
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
100549
AK
343900000X
Non-emergency Medical Transport (VAN)
Primary
7090913
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL 7902
—
AK
Enumeration date
05/27/2007
Last updated
03/29/2013
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