Organization
EDGAR LATTIMORES ASSISTED LIVING
Active
Organization
EDGAR LATTIMORES ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR LATTIMORE (OWNER/ ADMINISTRATOR)
(907) 830-8365
Entity
Organization
Contact information
Practice address
6320 MINK AVE, ANCHORAGE, AK 99504-2527
(907) 830-8365
Mailing address
6320 MINK AVE, ANCHORAGE, AK 99504-2527
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
100305
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94063
—
AK
Enumeration date
08/06/2007
Last updated
08/06/2007
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