Active NPI
Tranquility Manor Estates
- Assisted Living Facility
- Palmer, AK
National Provider Identifier
1164788071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 267
- Legal business name
- TRANQUILITY MANOR ESTATES
- Practice address
- 1950 Hemmer Road
Palmer, AK 99645 - Phone
- (907) 745-2012
- NPI assigned
- Apr 4, 2012
- Last updated
- Apr 4, 2012
- Organization subpart
- Yes
- Parent organization
- TRANQUILITY MANOR LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bruce Korman
- Title
- Officer
- Phone
- (907) 746-4220
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 100954 | AK | |
| Assisted Living Facility | 310400000X | 100719 | AK | |
| Assisted Living Facility | 310400000X | 267 | AK | Primary |
Addresses
Primary practice location
1950 Hemmer Road
Palmer, AK 99645
Mailing address
1205 N Tranquility LN
Palmer, AK 99645-8624
Phone (907) 746-4220
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RL4070 | Medicaid | AK | |
| RL4310 | Medicaid | AK |
National Provider Directory
National Provider Directory- Tax ID family
- Harbor View Manor
- Part of
- Harbor View Manor
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333497600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1333497600000",
"number": "1164788071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 N TRANQUILITY LN",
"city": "PALMER",
"state": "AK",
"postal_code": "996458624",
"telephone_number": "907-746-4220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 HEMMER ROAD",
"city": "PALMER",
"state": "AK",
"postal_code": "99645",
"telephone_number": "907-745-2012"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRANQUILITY MANOR ESTATES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TRANQUILITY MANOR LLC",
"enumeration_date": "2012-04-04",
"last_updated": "2012-04-04",
"status": "A",
"authorized_official_last_name": "KORMAN",
"authorized_official_first_name": "BRUCE",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "907-746-4220"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "AK",
"license": "100954",
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "AK",
"license": "100719",
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "AK",
"license": "267",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RL4070",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RL4310",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palmer, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.