Our Lady of Fatima

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

100559 Issued in AK

Legal business name

OUR LADY OF FATIMA

Practice address

4030 Defiance St
Anchorage, AK 99504-4368

Phone

(907) 529-7495

NPI assigned

Aug 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gina Gabat Nidoy

Title

Owner

Phone

(907) 529-7495

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1073704102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 DEFIANCE ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995044368",
            "telephone_number": "907-529-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 DEFIANCE ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995044368",
            "telephone_number": "907-529-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF FATIMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "NIDOY",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "GABAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-529-7495",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "100559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL7080",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Otutoa
• Joanna Oudal, APRN
• Daniel Ouellette, DPT
• Our Family Assisted Living Home
• Our Home Assisted Living Home,LLC
• Our Lady of Fatima LLC
• Our Lady of Grace Home
• Our Lady of Guadalupe LLC
• Our Lady of Guadalupe, L. L. C.
• Our Lady of Guadalupe, L.L.C

• Assisted Living Facility in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Assisted Living Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.