Healthcare Provider Details

I. General information

NPI: 1942400999
Provider Name (Legal Business Name): TREASURES ANGELS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 TUDOR RD
ANCHORAGE AK
99507
US

IV. Provider business mailing address

231933 POB
ANCHORAGE AK
99523
US

V. Phone/Fax

Practice location:
  • Phone: 907-332-1234
  • Fax:
Mailing address:
  • Phone: 907-332-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number740703
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number740703
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number740703
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number740703
License Number StateAK
# 5
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number740703
License Number StateAK
# 6
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number740703
License Number StateAK
# 7
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number740703
License Number StateAK
# 8
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number740703
License Number StateAK
# 9
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number740703
License Number StateAK
# 10
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number740703
License Number StateAK
# 11
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number740703
License Number StateAK

VIII. Authorized Official

Name: MONICA MARTINEZ
Title or Position: PRESIDENT
Credential:
Phone: 907-332-1234