MEDICARE: LYNNES HOME CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	100339	AK

General Provider Information

NPI Number	:	1003255860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYNNES HOME CARE

Provider Business Mailing Address
First Line	:	7730 WINCHESTER STREET
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-2856
Country	:	US
Telephone Number	:	907-952-1919
Fax Number	:	907-334-3392

Provider Business Practice Location Address
First Line	:	7730 WINCHESTER STREET
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-2856
Country	:	US
Telephone Number	:	907-952-1919
Fax Number	:	907-334-3392

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ERLINDA RIVERA
Credential	:
Telephone Number	:	907-952-1919

Provider Enumeration Date	:	06/14/2013
Last Update Date	:	06/14/2013

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Directions to “LYNNES HOME CARE ” Practice Location

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