Provider Demographics
NPI:1366748766
Name:MALETCH'S ASSISTED LIVING HOME
Entity type:Organization
Organization Name:MALETCH'S ASSISTED LIVING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALETCH
Authorized Official - Middle Name:DUCUT
Authorized Official - Last Name:PINEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-350-4933
Mailing Address - Street 1:8125 SANDY CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-3285
Mailing Address - Country:US
Mailing Address - Phone:907-350-4933
Mailing Address - Fax:907-349-8898
Practice Address - Street 1:8038 SANDY CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-3282
Practice Address - Country:US
Practice Address - Phone:907-349-8088
Practice Address - Fax:907-349-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100888310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility