Provider Demographics
NPI:1427259423
Name:FORGET-ME-NOT SENIOR CARE HOMES
Entity type:Organization
Organization Name:FORGET-ME-NOT SENIOR CARE HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:RATZLAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-488-5504
Mailing Address - Street 1:109 E 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-7774
Mailing Address - Country:US
Mailing Address - Phone:907-488-5504
Mailing Address - Fax:907-488-7979
Practice Address - Street 1:109 E 5TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-7774
Practice Address - Country:US
Practice Address - Phone:907-488-5504
Practice Address - Fax:907-488-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility