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Organization

GRACEFUL LIVING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTIANA ILOSEN ULOFOSHIO (ADMINISTRATOR)
(907) 338-3135
Entity
Organization

Contact information

Practice address
1100 FRIENDLY LN, 6600 EAST 11TH AVE, ANCHORAGE, AK 99504-2024
(907) 338-0444
(907) 338-5768
Mailing address
6300 E 9TH AVE, 1100 FRIENDLY LANE, ANCHORAGE, AK 99504-1720
(907) 338-3135
(907) 338-3012

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
34390000X
AK
344600000X
Taxi
3446OOOOX TAXI
AK
385H00000X
Respite Care
Primary
385HR0000X
AK
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
385HR2060
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1548461445
AK
05
HC3704
AK
Enumeration date
03/03/2008
Last updated
03/03/2008
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