Healthcare Provider Details

I. General information

NPI: 1487878237
Provider Name (Legal Business Name): MAJESTIC VIEW ASSISTED LIVING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 RACE RD
HOMER AK
99603-9328
US

IV. Provider business mailing address

PO BOX 3486
HOMER AK
99603-3486
US

V. Phone/Fax

Practice location:
  • Phone: 907-235-6413
  • Fax: 907-235-1228
Mailing address:
  • Phone: 907-235-6413
  • Fax: 907-235-1228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number159
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number159
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number159
License Number StateAK

VIII. Authorized Official

Name: MARIA SANTALUCIA
Title or Position: OWNER OPERATOR
Credential:
Phone: 907-235-6413