Provider Demographics
NPI:1174214894
Name:AURORA ASSISTED LIVING HOME LLC
Entity type:Organization
Organization Name:AURORA ASSISTED LIVING HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:ASIROT
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-382-2697
Mailing Address - Street 1:1641 CARA LOOP
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3851
Mailing Address - Country:US
Mailing Address - Phone:907-382-2697
Mailing Address - Fax:
Practice Address - Street 1:1641 CARA LOOP
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3851
Practice Address - Country:US
Practice Address - Phone:907-382-2697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty