NPIMap

Organization Active NPI

Parkside Assisted Living Inc

  • Respite Care
  • Anchorage, AK
National Provider Identifier
1508086604
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
112 Issued in AK
Legal business name
PARKSIDE ASSISTED LIVING INC
Practice address
309 E 24TH Ave
Anchorage, AK 99503-2105
Phone
(907) 276-0103
NPI assigned
Apr 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Leslee Orebaugh
Title
Administrator
Phone
(907) 276-0103

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X 112 AK Primary

Addresses

Primary practice location

309 E 24TH Ave
Anchorage, AK 99503-2105

Mailing address

PO Box 242423
Anchorage, AK 99524-2423

Other identifiers 2

IdentifierTypeStateIssuer
HC3924MedicaidAK
HC4132MedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Parkside Assisted Living Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508086604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242423",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995242423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 E 24TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032105",
            "telephone_number": "907-276-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE ASSISTED LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OREBAUGH",
        "authorized_official_first_name": "LESLEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-276-0103"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "AK",
            "license": "112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC3924",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC4132",
            "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 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.