Organization
OUR LADY OF GRACE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODELIA TAMILAG PACUDAN (ADMINISTRATOR)
(907) 868-8863
Entity
Organization
Contact information
Practice address
3730 W 74TH AVE, ANCHORAGE, AK 99502-2862
(907) 868-8863
(907) 868-8863
Mailing address
3730 W 74TH AVE, ANCHORAGE, AK 99502-2862
(907) 868-8863
(907) 868-8863
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
740505
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RL3014
—
AK
Enumeration date
05/11/2007
Last updated
03/03/2008
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