WASILLA RETIREMENT LLC NPI 1467696641

NPI Information

NPI: 1467696641
Provider Name: WASILLA RETIREMENT, LLC

Doing Business As: PRIMROSE RETIREMENT COMMUNITY OF WASILLA

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

Address:
889 N. ELKHORN DRIVE
WASILLA, AK
ZIP 99654
Phone: (907) 373-5500
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WASILLA RETIREMENT, LLC is an assisted living facility in Wasilla, AK. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. WASILLA RETIREMENT, LLC NPI is 1467696641. The provider is registered as an organization entity type.
The provider Is Doing Business As Primrose Retirement Community Of Wasilla.

The provider's business location address is:

889 N. ELKHORN DRIVE
WASILLA, AK
ZIP 99654
Phone: (907) 373-5500
Fax: (605) 725-8754

The provider's authorized official is Bonnie Jean Kelly .
The authorized official title is Director Of Nursing and has the following contact phone number (605) 226-3300.

The CLIA number assigned to this NPI record is 02D1096975 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/1/2009 and was last updated on 12/15/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	385H00000X	Respite Care		100747	ALASKA	No
2	310400000X	Assisted Living Facility				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	RL0010	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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