Serene Grace Assisted Living Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

101074 Issued in AK

Legal business name

SERENE GRACE ASSISTED LIVING HOME

Doing business as

Mirasol Williams

Practice address

3639 E 74TH Ave
Anchorage, AK 99507-2829

Phone

(907) 272-4073

Fax

(907) 552-1626

NPI assigned

Feb 26, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Mirasol Cariaga Williams

Title

Administrator

Phone

(907) 244-1765

Specialties & licenses 1

Addresses

Other names 1

• Mirasol Williams Doing business as

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424908800000",
    "number": "1790177764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3639 E 74TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995072829",
            "telephone_number": "907-272-4073",
            "fax_number": "907-552-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3639 E 74TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995072829",
            "telephone_number": "907-272-4073",
            "fax_number": "907-552-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE GRACE ASSISTED LIVING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-26",
        "last_updated": "2015-02-26",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MIRASOL",
        "authorized_official_middle_name": "CARIAGA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-244-1765",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "101074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mirasol Williams",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Assisted Living Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; 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.