Healthcare Provider Details

I. General information

NPI: 1083760433
Provider Name (Legal Business Name): GENTLE CARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2217 E TUDOR RD STE 11
ANCHORAGE AK
99507-1074
US

IV. Provider business mailing address

PO BOX 210672 PO BOX 210672
ANCHORAGE AK
99521-0672
US

V. Phone/Fax

Practice location:
  • Phone: 907-644-7952
  • Fax: 907-644-7953
Mailing address:
  • Phone: 907-644-7952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHC6161-DSDS CERT.
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License NumberPCG6161-DSDS CERT.
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number100558
License Number StateAK

VIII. Authorized Official

Name: NGOZI GERALD ISOLOKWU
Title or Position: PRESIDENT
Credential:
Phone: 907-884-0906