Provider Demographics
NPI:1649524182
Name:ANCHORAGE ADULT DAY SERVICES
Entity type:Organization
Organization Name:ANCHORAGE ADULT DAY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JERLYN
Authorized Official - Middle Name:SALAZAR
Authorized Official - Last Name:ODRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-350-3098
Mailing Address - Street 1:8037 COUNTRY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-4691
Mailing Address - Country:US
Mailing Address - Phone:907-350-3098
Mailing Address - Fax:907-522-5322
Practice Address - Street 1:360 BONIFACE PARKWAY, SUITE B8
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504
Practice Address - Country:US
Practice Address - Phone:907-868-4988
Practice Address - Fax:907-868-4998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK972572311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home