The Marietta House

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

101094 Issued in AK

Legal business name

THE MARIETTA HOUSE

Practice address

3832 Young St
Anchorage, AK 99508-4548

Phone

(907) 222-1164

Fax

(907) 222-1164

NPI assigned

Jan 12, 2016

Organization subpart

No

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

Authorized official

Name

Alexander J Lomel

Title

Owner

Phone

(907) 222-1164

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452556800000",
    "number": "1457717035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3832 YOUNG ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084548",
            "telephone_number": "907-222-1164",
            "fax_number": "907-222-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3832 YOUNG ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084548",
            "telephone_number": "907-222-1164",
            "fax_number": "907-222-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MARIETTA HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A",
        "authorized_official_last_name": "LOMEL",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-222-1164"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "AK",
            "license": "101094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RLX",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Disabilities Residential Treatment Facility in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Physical Disabilities Residential Treatment Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.