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General NPI Number Information
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NPI Number | 1831809953
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Entity Type | Organization
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Legal Business Name | EMMANEL ASSISTED LIVING HOME WEST, INC.
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Dates
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Enumeration Date | 11/29/2022
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 70 STEELHEAD RD
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City | FAIRBANKS
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State | AK
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Zip | 99709-3035
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Country | US
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Telephone | 907-750-6785
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Fax | 877-620-9084
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Provider Business Mailing Address
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Address Line | 70 STEELHEAD RD
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City | FAIRBANKS
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State | AK
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Zip | 99709-3035
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Country | US
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Telephone | 907-750-6785
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Fax | 877-620-9084
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. VALERIA CRISTINA CASTRO
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Credential |
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Telephone | 907-750-6785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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