Northern Lights Care Assisted Living Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

100587 Issued in AK

Legal business name

NORTHERN LIGHTS CARE ASSISTED LIVING HOME

Practice address

3720 Gardner St
Anchorage, AK 99508-4954

Phone

(907) 646-7881

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Carmen Maravillas Bombarda

Title

Administrator

Phone

(907) 644-7881

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1992996904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 GARDNER ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084954",
            "telephone_number": "907-646-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 GARDNER ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084954",
            "telephone_number": "907-646-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LIGHTS CARE ASSISTED LIVING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "BOMBARDA",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "MARAVILLAS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-644-7881",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "100587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Northern Lights Eye Care Inc.

• 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 Aug 5, 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.