| Organization Name: | DIVINE MERCY II ALH, LLC |
| NPI Number: | 1528358207 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELIEZER LIMUN PENTECOSTES (OWNER/ADMINISTRATOR) |
| Mailing Address: | 417 E 11th Ave Apt 5 Anchorage |
| State: | AK US |
| Postal Code: | 995014560 |
| Phone Number: | 9077709148 |
| Fax Number: | 9077709149 |
| NPI Enumeration Date: | 04/14/2011 |
| NPI Last Update Date: | 09/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | 100892 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AK |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |