Sue'S Sourdough Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

100415 Issued in AK

Legal business name

SUE'S SOURDOUGH ASSISTED LIVING LLC

Practice address

14650 Park Hills Dr
Anchorage, AK 99516-4241

Phone

(907) 345-1854

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Susan Cress

Title

Direct Owner

Phone

(907) 345-1854

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Sue'S Sourdough Assisted Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sue'S Sourdough Assisted Living

  • Respite Care
  • Anchorage, AK
  • NPI 1023233533
  NPD tax ID

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114140456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110041",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995110041",
            "telephone_number": "907-345-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 PARK HILLS DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995164241",
            "telephone_number": "907-345-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUE'S SOURDOUGH ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRESS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "907-345-1854",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "100415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL3740",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Escara Subba
• George Subeldia
• Latha Subramanian, M.D.
• Kristine Sudaria, RN
• Sue'S Sourdough Assisted Living
• Ian E Sugabo
• Sugarloaf Care Coordination, LLC
• Allison Suis
• Lance A Suiter
• Sach M. Suitt, LDO

• 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 22, 2020; 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.