NPIMap

Organization Active NPI

Elenas Place Corporation

  • Health Service Clinic/Center
  • Anchorage, AK
National Provider Identifier
1295911212
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
000156 Issued in AK
Legal business name
ELENAS PLACE CORPORATION
Practice address
8611 Arctic Blvd # 1
Same
Anchorage, AK 99515-1708
Phone
(907) 336-9090
Fax
(907) 336-9090
NPI assigned
Jan 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Rodolfo Domondon Regacho, ELEMENTARY TEACHER
Title
Administrator
Phone
(907) 336-9090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 000156 AK Primary

Addresses

Primary practice location

8611 Arctic Blvd # 1
Same
Anchorage, AK 99515-1708

Mailing address

8611 Arctic Blvd # 1
Same
Anchorage, AK 99515-1708
Phone (907) 336-9090

Other identifiers 1

IdentifierTypeStateIssuer
RL82901MedicaidAK

Other names 1

  • Good Samaritan Assisted Living Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elena'S Place Corporation4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

8611 Arctic Blvd
#1
Anchorage, AK 99515
Phone (907) 336-9090

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1295911212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8611 ARCTIC BLVD # 1",
            "address_2": "SAME",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995151708",
            "telephone_number": "907-336-9090",
            "fax_number": "907-336-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8611 ARCTIC BLVD # 1",
            "address_2": "SAME",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995151708",
            "telephone_number": "907-336-9090",
            "fax_number": "907-336-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELENAS PLACE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "REGACHO",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_middle_name": "DOMONDON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-336-9090",
        "authorized_official_credential": "ELEMENTARY TEACHER"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AK",
            "license": "000156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL82901",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Assisted Living Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.