Healthcare Provider Details

I. General information

NPI: 1437918026
Provider Name (Legal Business Name): HOME BOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 03/15/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 C ST STE 204
ANCHORAGE AK
99501-5164
US

IV. Provider business mailing address

1577 C ST STE 204
ANCHORAGE AK
99501-5164
US

V. Phone/Fax

Practice location:
  • Phone: 907-205-6912
  • Fax:
Mailing address:
  • Phone: 907-205-6912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: JILL MCCORMICK
Title or Position: OWNER
Credential: RN
Phone: 907-205-6912