Provider Demographics
NPI:1689476855
Name:PLEASANT VALLEY ASSISTED LIVING HOME, LLC.
Entity type:Organization
Organization Name:PLEASANT VALLEY ASSISTED LIVING HOME, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SEVERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-317-5050
Mailing Address - Street 1:PO BOX 210135
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99521
Mailing Address - Country:US
Mailing Address - Phone:907-644-3956
Mailing Address - Fax:
Practice Address - Street 1:3300 CHERRY ST.
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504
Practice Address - Country:US
Practice Address - Phone:907-644-3956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility