NPIMap

Organization Active NPI

Harbor View Manor

Doing business as Tranquility Manor

  • Assisted Living Facility
  • Wasilla, AK
National Provider Identifier
1700103173
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
HARBOR VIEW MANOR
Doing business as
Tranquility Manor
Practice address
4070 S Birch Cove Dr
Wasilla, AK 99654-9456
Phone
(907) 746-4220
NPI assigned
Apr 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Authorized official

Name
Mr. Bruce Korman
Title
Director/Owner
Phone
(907) 357-2019

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

4070 S Birch Cove Dr
Wasilla, AK 99654-9456

Mailing address

1205 N Tranquility LN
Palmer, AK 99645-8624

Other identifiers 1

IdentifierTypeStateIssuer
RL 4070MedicaidAK

Other names 1

  • Tranquility Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tranquility Manor LLC3 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.

Locations

4070 S Birch Cove Dr
Wasilla, AK 99623
Phone (907) 357-2019

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1700103173",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 S BIRCH COVE DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996549456",
            "telephone_number": "907-746-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR VIEW MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "KORMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "907-357-2019",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL 4070",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tranquility Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.