Healthcare Provider Details

I. General information

NPI: 1023816923
Provider Name (Legal Business Name): ANCHORAGE ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3935 REKA DR
ANCHORAGE AK
99508-3517
US

IV. Provider business mailing address

3935 REKA DR
ANCHORAGE AK
99508-3517
US

V. Phone/Fax

Practice location:
  • Phone: 907-406-5640
  • Fax:
Mailing address:
  • Phone: 907-406-5640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARINELLE DIAMANTE MANTOJAC
Title or Position: OPERATOR
Credential:
Phone: 907-406-5640