=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700759040
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROMARC HOMES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/24/2025
-----------------------------------------------------
Last Update Date | 09/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8151A WILLIWA AVE
-----------------------------------------------------
City | ANCHORAGE
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99504-4169
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-250-9192
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7321 E CHESTER HEIGHTS CIR
-----------------------------------------------------
City | ANCHORAGE
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99504-3565
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-250-9192
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DESIGNEE
-----------------------------------------------------
Name | SIR RITCHIE MACAM ROMERO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 907-250-9192
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 376G00000X
-----------------------------------------------------
Taxonomy Name | Nursing Home Administrator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------