Healthcare Provider Details

I. General information

NPI: 1831825678
Provider Name (Legal Business Name): SANPIERRE ASSISTED LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 07/25/2022
Certification Date: 07/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7481 S TERRITORIAL DR
WASILLA AK
99623-1145
US

IV. Provider business mailing address

5028 E CALF CIR
WASILLA AK
99654-0041
US

V. Phone/Fax

Practice location:
  • Phone: 907-232-7947
  • Fax: 907-357-2271
Mailing address:
  • Phone: 907-232-7947
  • Fax: 907-357-2271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: RUTH TASSIE
Title or Position: PRESIDENT
Credential:
Phone: 907-232-7947