Provider Demographics
NPI:1043504608
Name:ROMANA II ALH L.L.C.
Entity type:Organization
Organization Name:ROMANA II ALH L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTIAGO
Authorized Official - Middle Name:M
Authorized Official - Last Name:MANITI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-229-7240
Mailing Address - Street 1:1023 E 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3939
Mailing Address - Country:US
Mailing Address - Phone:907-229-7240
Mailing Address - Fax:
Practice Address - Street 1:1023 E 28TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3939
Practice Address - Country:US
Practice Address - Phone:907-229-7240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100872320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities