Provider Demographics
NPI:1154758068
Name:PRECIOUS CARE ASSISTED LIVING FACILITY, LLC
Entity type:Organization
Organization Name:PRECIOUS CARE ASSISTED LIVING FACILITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMONISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EURONIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MACLACHLAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-227-5421
Mailing Address - Street 1:3773 SCENIC VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504
Mailing Address - Country:US
Mailing Address - Phone:907-227-5421
Mailing Address - Fax:907-868-3721
Practice Address - Street 1:3773 SCENIC VIEW DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-6600
Practice Address - Country:US
Practice Address - Phone:907-227-5421
Practice Address - Fax:907-868-3721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101012310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKRLX,HCXMedicaid