NPI 1700563301
Big Lake Country Club, LLC
Practice location
- Address
- 12528 W. Hawk Lane, Houston, AK 99694
- Phone
- (907) 232-8466
- Mailing address
- PO Box 520069, Big Lake, AK 99652-0069
Authorised official
- Name
- Stephen Phillip Geddes
- Title
- Manager
- Phone
- (907) 250-6605
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1700563301
- Entity type
- Organization
- NPI issued
- 5 Jul 2023
- 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.