JEWEL LAKE ASSISTED LIVING HOME LLC (NPI# 1255761987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255761987 |
| Entity Type | Organization |
| Organization Name | JEWEL LAKE ASSISTED LIVING HOME LLC |
| Practice Address |
4132 W 88th Ave Anchorage AK 99502-5107 |
| Mailing Address |
4132 West 88th Ave. Anchorage AK 99502 |
| Practice Telephone | 9072439570 |
| Practice Fax Number | 9072450035 |
| Mailing Telephone | 9072439570 |
| Mailing Fax Number | 9072450035 |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2013-11-15 |
| Authorized Official Name | MR. ARTHUR REYES BONGLO (ADMINISTRATOR) |
| Authorized Official Telephone | 9072439570 |
| Authorized Official Credential | REGISTERED NURSE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 101014 | AK | Nursing & Custodial Care Facilities |
| Street Address |
4132 W 88TH AVE |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99502-5107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073157897 | Thelma Desjarlais | Case Manager/Care Coordinator | 9201 Shorecrest Drive, Anchorage, AK 99502 | 2019-11-05 |
| 1659851038 | Vonice LLC | Pharmacy | 4311 W Lake Cir, Anchorage, AK 99502 | 2018-08-15 |
| 1447736798 | Kelly Wilson | Assisted Living Facility | 8848 Gloralee St, Anchorage, AK 99502 | 2018-07-18 |
| 1912405770 | In His Image LLC | Custodial Care Facility | 2253 Mistybrook Cir, Anchorage, AK 99502 | 2018-01-26 |
| 1316344963 | Alaska Regional Life Flight Corporation | Ambulance | 3474 Old International Airport Road, Anchorage, AK 99502 | 2014-11-25 |
| 1164827101 | Dante Kun | Counselor | 8000 West End Rd. (pt. Woronzof), Anchorage, AK 99502 | 2014-11-04 |
| 1407256357 | Kayli Ellingson | Pharmacist | 7020 Northwood Drive, 102, Anchorage, AK 99502 | 2014-08-28 |
| 1801168620 | Mckenzie Assisted Living | Clinic/Center | 8812 Hamlet Circle, 8812 Hamlet Circle, Anchorage, AK 99502 | 2012-02-09 |
| 1568623106 | South Anchorage Dental Clinic LLC | Dental Assistant | 9170 Jewel Lake Road, Suite 201, Anchorage, AK 99502 | 2008-06-17 |
| 1154580611 | Tonia Marie Taylor | Assisted Living Facility | 2821 Ruby Drive, Anchorage, AK 99502 | 2008-06-09 |
| Find all providers in zip 99502 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164042 | Liveable Soulutions | Assisted Living Facility | 1504 W 47th Ave Unit B, Anchorage, AK 99503-6924 | 2020-11-02 |
| 1699372656 | Kathleen Corleto | Assisted Living Facility | 3180 Amanda Gayle Cir, Anchorage, AK 99507-2602 | 2020-10-02 |
| 1336754969 | Snow City Assisted Living Home, LLC | Assisted Living Facility | 2634 Carroll Pl Unit B, Anchorage, AK 99508-3821 | 2020-09-10 |
| 1750991733 | Uba Alh | Assisted Living Facility | 6730 E 10th Ave, Anchorage, AK 99504-1814 | 2020-08-05 |
| 1184233116 | Mckinley Care LLC | Assisted Living Facility | 337 E 4th Ave Unit B, Anchorage, AK 99501-2664 | 2020-07-27 |
| 1154949949 | Patrick L Sullivan | Assisted Living Facility | 3314 Dickson Rd, Anchorage, AK 99504-4035 | 2020-07-08 |
| 1699392035 | Open Arms Assisted Living West LLC | Assisted Living Facility | 3660 W 78th Ave, Anchorage, AK 99502-4471 | 2020-07-01 |
| 1760004998 | Guardian Angel | Assisted Living Facility | 8403 Mentra St, Anchorage, AK 99518-2906 | 2020-05-11 |
| 1235761230 | Golden Years LLC | Assisted Living Facility | 2941 Morgan Loop, Anchorage, AK 99516 | 2020-02-07 |
| 1710528435 | A Legacy Home Care, LLC | Assisted Living Facility | 6347 Rose Hip Cir, Anchorage, AK 99507-5457 | 2019-10-03 |
| Find all providers in ANCHORAGE | ||||
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| 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.