Organization Name: | TLC ASSISTED LIVING HOME |
NPI Number: | 1851514624 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILMA ERIBAL TANNER (ADMINISTRATOR, OWNER) |
Mailing Address: | 2401 Oak Dr Anchorage |
State: | AK US |
Postal Code: | 995083267 |
Phone Number: | 9072780308 |
Fax Number: | 9072780408 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 06/25/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | RL5743 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AK |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |