KIWI ASSISTED LIVING HOME III (NPI# 1245591940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245591940 |
| Entity Type | Organization |
| Organization Name | KIWI ASSISTED LIVING HOME III |
| Practice Address |
2948 Princeton Way Anchorage AK 99508-4479 |
| Practice Telephone | 9072275573 |
| Practice Fax Number | 9072742752 |
| Mailing Telephone | 9072275573 |
| Mailing Fax Number | 9072742752 |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-10-17 |
| Authorized Official Name | MR. ROY BOLLOZOS FRANCISCO (OWNER) |
| Authorized Official Telephone | 9072275573 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
AK | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | 1770606543 | 05 |
| Street Address |
2948 PRINCETON WAY |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-4479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407476161 | Alaska Olive Care II, LLC | Custodial Care Facility | 708 N Bunn St, Anchorage, AK 99508-1695 | 2020-04-23 |
| 1952883266 | Quality & Quantity Care Services LLC | Custodial Care Facility | 848 Elaine Dr, Anchorage, Ak, 99504, The Same, Anchorage, AK 99504 | 2018-09-04 |
| 1649524182 | Anchorage Adult Day Services | Custodial Care Facility | 360 Boniface Parkway, Suite B8, Anchorage, AK 99504 | 2012-11-06 |
| 1932482619 | Elaine's Place | Custodial Care Facility | 1025 H St, Anchorage, AK 99501-3430 | 2011-09-20 |
| 1144509365 | Abuelita Alh, LLC | Custodial Care Facility | 1105 San Antonio St, Anchorage, AK 99508-2764 | 2011-08-04 |
| 1114150513 | Gloria's Golden Heart Assisted Living, LLC | Custodial Care Facility | 3713 Robin St, Anchorage, AK 99504-4674 | 2009-09-01 |
| 1003090176 | Comfort Assisted Living Homes | Custodial Care Facility | 7370 Winchester St, Anchorage, AK 99507-2856 | 2007-12-24 |
| 1548461445 | Graceful Living LLC | Custodial Care Facility | 6300 E 9th Ave, Anchorage, AK 99504-1720 | 2007-05-29 |
| 1104957760 | Comfort Assisted Living Home | Custodial Care Facility | 7390 Winchester St, Anchorage, AK 99507-2856 | 2007-03-08 |
| 1942546155 | Alpine Assisted Living Home | Custodial Care Facility | 7951 Alpine View Cir, Anchorage, AK 99507-5707 | 2012-12-14 |
| Find all providers in ANCHORAGE | ||||
Please comment or provide details below to improve the information on KIWI ASSISTED LIVING HOME III.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.