Provider Demographics
NPI:1316701899
Name:ALASKAN AGAPE CARE LLC
Entity type:Organization
Organization Name:ALASKAN AGAPE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOAB
Authorized Official - Middle Name:TAN
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-792-9365
Mailing Address - Street 1:7913 ARLENE STREET
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-4529
Mailing Address - Country:US
Mailing Address - Phone:907-792-9365
Mailing Address - Fax:907-416-7265
Practice Address - Street 1:7913 ARLENE STREET
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-4529
Practice Address - Country:US
Practice Address - Phone:907-792-9365
Practice Address - Fax:907-416-7265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility