WOLVERINE ACADEMY LLC NPI 1881993749

NPI Information

NPI: 1881993749
Provider Name: WOLVERINE ACADEMY, LLC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
15700 E CLARK RD
PALMER, AK
ZIP 99645
Phone: (907) 746-3442
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WOLVERINE ACADEMY, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Palmer, AK. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. WOLVERINE ACADEMY, LLC NPI is 1881993749. The provider is registered as an organization entity type.

The provider's business location address is:

15700 E CLARK RD
PALMER, AK
ZIP 99645-705
Phone: (907) 746-3442
Fax: (907) 746-4847

The provider's authorized official is Kelly Ann Barrett-godwin .
The authorized official title is Owner/designee and has the following contact phone number (907) 746-3442.

The enumeration date for this NPI number is 3/17/2011 and was last updated on 3/17/2011.

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	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		942851	ALASKA	Yes

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: 4/28/2024

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