Big Lake Country Club in Wasilla - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Big Lake Country Club - NPI 1154580835
Big Lake Country Club is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Wasilla, Alaska. Big Lake Country Club practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Big Lake Country Club is 1154580835. The last update date is 2009-07-22.
Big Lake Country Club's current location address is Po Box 299136, Wasilla, Alaska. You can contact this provider via phone number 9078926944. The mailing address for Big Lake Country Club is Po Box 299136, Wasilla, Alaska. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Big Lake Country Club |
|---|---|
| Address | Po Box 299136, Wasilla, Alaska |
| Phone Number | 9078926944 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | STAFF OFFI |
|---|---|
| Authorized Official Name | Adams G Jess |
| Telephone Number | 9078926944 |
NPI Number Detail
| NPI Number | 1154580835 |
|---|---|
| Provider Enumeration Date | 2008-06-06 |
| Last Updated Date | 2009-07-22 |
Provider Mailing Address Detail
| Address | Po Box 299136 |
|---|---|
| City | Wasilla |
| State | Alaska (AK) |
| Post Code | 996299136 |
| Phone Number | 9078926944 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320900000X |
| Licence No | 100554 |
|
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| HC78981 | AK | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Big Lake Country Club by the Centers for Medicare & Medicaid Services?
The Big Lake Country Club has been assigned the NPI (National Provider Identifier) 1154580835 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete address where Big Lake Country Club is physically located?
The Big Lake Country Club is situated at the following address: Po Box 299136, Wasilla, AK 996299136.
What is the area of specialization for Big Lake Country Club, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Big Lake Country Club is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this area of expertise is 320900000X.
On what date did the Big Lake Country Club receive the assignment of its 1154580835 from the Centers for Medicare & Medicaid Services?
The Big Lake Country Club was issued its 1154580835 by the Centers for Medicare & Medicaid Services on 2008-06-06.
As of what date were the Big Lake Country Club's details last updated?
The information pertaining to the Big Lake Country Club, including its address, specialty, and other details, was most recently updated on 2009-07-22.
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