NPI 1639497415

Big Lake Country Club, LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Houston, AK

Practice location

Address: 12528 Hawk Lane, Houston, AK 99694
Phone: (907) 892-6944
Mailing address: PO Box 299136, Wasilla, AK 99629

Authorised official

Name: Lynda Plettner
Title: President / Administrator
Phone: (907) 892-6944

Registered specialties (3)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 940288 (AK)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Alaska →

Case Management Agency

Agencies Taxonomy 251B00000X Licence CMG (AK)

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Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X Licence HCS (AK)

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Registry record

NPI: 1639497415
Entity type: Organization
NPI issued: 4 May 2010
Record last updated: 5 Jul 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.