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NPI Code Detail

MEDICARE: MARY GRACE SACULLES

MEDICARE: MARY GRACE SACULLES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant
2373H00000XDay Training/Habilitation Specialist

General Provider Information

NPI Number : 1184368425
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY GRACE SACULLES
Provider Business Mailing Address
First Line : 1550 E 74TH AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-2614
Country : US
Telephone Number : 907-929-5826
Fax Number :
Provider Business Practice Location Address
First Line : 1550 E 74TH AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-2614
Country : US
Telephone Number : 907-929-5826
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2022
Last Update Date : 04/22/2022

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Directions to “ MARY GRACE SACULLES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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