BIG LAKE COUNTRY CLUB, LLC – NPI #1639497415
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

BIG LAKE COUNTRY CLUB, LLC is a community based residential treatment facility located in HOUSTON, AK. NPPES has assigned the NPI number 1639497415 to BIG LAKE COUNTRY CLUB, LLC on May 04, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

The NPI profile was previously updated about 3 years ago on Jul 05, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BIG LAKE COUNTRY CLUB, LLC below.

NPI Profile for
BIG LAKE COUNTRY CLUB, LLC

NPI Number
1639497415
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BIG LAKE COUNTRY CLUB, LLC
Primary location
12528 HAWK LANE
HOUSTON, AK 99694
Phone: (907) 892-6944 Fax:
Mailing address
PO BOX 299136
WASILLA, AK 99629
Phone: (907) 892-6944 Fax:
Organization Subpart
No
Authorized Official
LYNDA PLETTNER
PRESIDENT / ADMINISTRATOR
Phone: (907) 892-6944
Updated
Certification Date
Jul 05, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)		 AK 940288
251S00000X
- Community/Behavioral Health		 AK HCS
251B00000X
- Case Management		 AK CMG

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.