Healthcare Provider Details

I. General information

NPI: 1023159266
Provider Name (Legal Business Name): ALASKA HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 03/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 N CRESTE FORIS ST STE A
WASILLA AK
99654-5651
US

IV. Provider business mailing address

PO BOX 872501
WASILLA AK
99687-2501
US

V. Phone/Fax

Practice location:
  • Phone: 907-357-5431
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: NATALIYA ZHUCHKOV
Title or Position: PRESIDENT
Credential:
Phone: 907-357-5431