Healthcare Provider Details

I. General information

NPI: 1124244306
Provider Name (Legal Business Name): TURNAGAIN FOSTER HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 WEST 29TH AVE
ANCHORAGE AK
99517
US

IV. Provider business mailing address

2812 WEST 29TH AVE
ANCHORAGE AK
99517
US

V. Phone/Fax

Practice location:
  • Phone: 907-245-1811
  • Fax: 907-868-1795
Mailing address:
  • Phone: 907-245-1811
  • Fax: 907-868-1795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number000010
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number000010
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number00090
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number000298
License Number StateAK
# 5
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number420796
License Number StateAK

VIII. Authorized Official

Name: MILAGROS VINA JENNINGS
Title or Position: ADMINISTRATOR
Credential:
Phone: 907-868-1795