Provider Demographics
NPI: | 1831825678 |
---|---|
Name: | SANPIERRE ASSISTED LIVING, LLC |
Entity type: | Organization |
Organization Name: | SANPIERRE ASSISTED LIVING, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RUTH |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TASSIE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 907-232-7947 |
Mailing Address - Street 1: | 5028 E CALF CIR |
Mailing Address - Street 2: | |
Mailing Address - City: | WASILLA |
Mailing Address - State: | AK |
Mailing Address - Zip Code: | 99654-0041 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 907-232-7947 |
Mailing Address - Fax: | 907-357-2271 |
Practice Address - Street 1: | 7481 S TERRITORIAL DR |
Practice Address - Street 2: | |
Practice Address - City: | WASILLA |
Practice Address - State: | AK |
Practice Address - Zip Code: | 99623-1145 |
Practice Address - Country: | US |
Practice Address - Phone: | 907-232-7947 |
Practice Address - Fax: | 907-357-2271 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-07-25 |
Last Update Date: | 2022-07-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
No | 261QR0400X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |