MEDICARE: CARE FOR LIFE INC DBA COMFORT CARE HOME II

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	385H00000X	Respite Care
2	310400000X	Assisted Living Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720785652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE FOR LIFE INC DBA COMFORT CARE HOME II

Provider Business Mailing Address
First Line	:	7370 WINCHESTER ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-2856
Country	:	US
Telephone Number	:	907-644-9003
Fax Number	:

Provider Business Practice Location Address
First Line	:	7370 WINCHESTER ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99507-2856
Country	:	US
Telephone Number	:	907-644-9003
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JIM KIM
Credential	:
Telephone Number	:	907-830-3772

Provider Enumeration Date	:	02/10/2023
Last Update Date	:	02/10/2023

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