Organization
PROVIDENCE HEALTH & SERVICES-WASHINGTON
Active
Other names
Providence Horizon House
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA MARIE GLEASON RN (INTERIM DIRECTOR)
(907) 261-4167
Entity
Organization
Contact information
Practice address
3760 PIPER ST, SUITE 1061, ANCHORAGE, AK 99508-4683
(907) 212-0256
(907) 212-6547
Mailing address
4140 FOLKER ST, ANCHORAGE, AK 99508-5323
(907) 261-4140
(907) 261-4160
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
279763
AK
311500000X
Alzheimer Center (Dementia Center)
279763
AK
385H00000X
Respite Care
279763
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004814
—
AK
05
—
1030242
—
AK
05
—
1030243
—
AK
Enumeration date
07/23/2006
Last updated
08/21/2014
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