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Big Lake Country Club, Llc
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Houston, Alaska
NPI 1669150207

Big Lake Country Club, Llc is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Big Lake, AK. Big Lake Country Club, Llc practices in Houston, AK. The NPI Number for Big Lake Country Club, Llc is 1669150207 and holds a License No. (Alaska).

The current practice location address for Big Lake Country Club, Llc is 471 S. Kenlar Road, Houston, AK and can be reached out via phone at 907-232-8466.

Location: 471 S. Kenlar Road, Houston, AK, 99652-0069
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1669150207
Provider Name
Big Lake Country Club, Llc
Credential
Provider Entity Type
Organization
Address
471 S. Kenlar Road, Houston, AK, 99652-0069
Phone Number
907-232-8466
Fax Number
Provider Enumeration Date
07/05/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
471 S. Kenlar Road
City
Houston
State
Alaska
Zip
99694
Phone Number
907-232-8466
Fax Number
person
Provider Business Mailing Address Details
Address
471 S. Kenlar Road
City
Houston
State
Alaska
Zip
99694
Phone Number
907-232-8466
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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