=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649181181
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ST. CLARE ALH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2026
-----------------------------------------------------
Last Update Date | 09/14/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3512 COPE ST
-----------------------------------------------------
City | ANCHORAGE
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99503-4535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-418-0101
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3512 COPE ST
-----------------------------------------------------
City | ANCHORAGE
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99503-4535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-418-0101
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | ANTONINA AQUINO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 907-418-0101
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------