NPI 1033617881

Supreme Home LLC

Organisation Custodial Care Facility Anchorage, AK

Practice location

Address: 1735 Minerva Way, Anchorage, AK 99515-1490
Phone: (907) 334-6468
Fax: (907) 868-4670

Authorised official

Name: Ajoke Olohima Walker Kolawole
Title: Administrator
Phone: (907) 830-6959

Registered specialties (3)

Custodial Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311Z00000X

Other Custodial Care Facility providers in Alaska →

Assisted Living Facility

Nursing & Custodial Care Facilities Taxonomy 310400000X

Other Assisted Living Facility providers in Alaska →

Assisted Living Facility (Behavioral Disturbances)

Nursing & Custodial Care Facilities Taxonomy 3104A0630X

Registry record

NPI: 1033617881
Entity type: Organization
NPI issued: 26 Jan 2018
Record last updated: 26 Jan 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.