Provider Demographics
NPI:1194960476
Name:SUNRISE POINT ALH
Entity type:Organization
Organization Name:SUNRISE POINT ALH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMPHONE
Authorized Official - Middle Name:
Authorized Official - Last Name:PHOUMMANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-339-9440
Mailing Address - Street 1:1752 WILDBERRY LOOP
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-3203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2620 MELVIN AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-3276
Practice Address - Country:US
Practice Address - Phone:907-339-9440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK913244310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility