Healthcare Provider Details

I. General information

NPI: 1386867315
Provider Name (Legal Business Name): THE SALVATION ARMY OLDER ALASKANS PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W INTL AIRPORT RD SUITE 19
ANCHORAGE AK
99518-1104
US

IV. Provider business mailing address

143 E 9TH AVE
ANCHORAGE AK
99501-3618
US

V. Phone/Fax

Practice location:
  • Phone: 907-349-0613
  • Fax:
Mailing address:
  • Phone: 907-339-3406
  • Fax: 907-276-2611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number11806
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number11806
License Number StateAK

VIII. Authorized Official

Name: ADELANE M KELLY
Title or Position: DIVISIONAL FINANCE DIRECTOR
Credential:
Phone: 907-339-3406