Edgar Lattimores Assisted Living | |
6320 Mink Ave Anchorage AK 99504-2527 | |
(907) 830-8365 | |
Not Available |
Full Name | Edgar Lattimores Assisted Living |
---|---|
Speciality | Community/behavioral Health |
Location | 6320 Mink Ave, Anchorage, Alaska |
Authorized Official Name and Position | Edgar Lattimore (OWNER/ ADMINISTRATOR) |
Authorized Official Contact | 9078308365 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Edgar Lattimores Assisted Living 6320 Mink Ave Anchorage AK 99504-2527 Ph: () - | Edgar Lattimores Assisted Living 6320 Mink Ave Anchorage AK 99504-2527 Ph: (907) 830-8365 |
NPI Number | 1962693812 |
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Provider Enumeration Date | 08/06/2007 |
Last Update Date | 08/06/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962693812 | NPI | - | NPPES |
94063 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 100305 (Alaska) | Primary |
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