NPIMap

Organization Active NPI

Our Lady of Guadalupe LLC

  • Respite Care
  • Anchorage, AK
National Provider Identifier
1407039746
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
HC# PENDING Issued in AK
Legal business name
OUR LADY OF GUADALUPE LLC
Practice address
8211 Majestic Dr
Anchorage, AK 99504-4702
Phone
(907) 338-9588
Fax
(907) 644-7944
NPI assigned
Dec 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Authorized official

Name
Analiza Y Pentecostes
Title
Administrator
Phone
(907) 338-9588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X HC# PENDING AK Primary

Addresses

Primary practice location

8211 Majestic Dr
Anchorage, AK 99504-4702

Mailing address

8211 Majestic Dr
Anchorage, AK 99504-4702
Phone (907) 338-9588

Other identifiers 1

IdentifierTypeStateIssuer
HC# PENDINGMedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Our Lady of Guadalupe LLC4 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.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1407039746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8211 MAJESTIC DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995044702",
            "telephone_number": "907-338-9588",
            "fax_number": "907-644-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8211 MAJESTIC DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995044702",
            "telephone_number": "907-338-9588",
            "fax_number": "907-644-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF GUADALUPE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "PENTECOSTES",
        "authorized_official_first_name": "ANALIZA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-338-9588"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "AK",
            "license": "HC# PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC# PENDING",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 12, 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.