Blueberry Lodge B&B

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

100284 Issued in AK

Legal business name

BLUEBERRY LODGE B&B

Doing business as

Blueberry Lodge Assisted Living Home

Practice address

9436 N Douglas Hwy
Juneau, AK 99801-7649

Phone

(907) 463-5886

Fax

(907) 463-5886

NPI assigned

Apr 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Judy Fay Urquhart

Title

Administrator

Phone

(907) 463-5886

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Blueberry Lodge Assisted Living Home Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1013135649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9436 N DOUGLAS HWY",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017649",
            "telephone_number": "907-463-5886",
            "fax_number": "907-463-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9436 N DOUGLAS HWY",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017649",
            "telephone_number": "907-463-5886",
            "fax_number": "907-463-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBERRY LODGE B&B",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "URQUHART",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "FAY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-463-5886",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AK",
            "license": "100284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC5192",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blueberry Lodge Assisted Living Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Benjamin Blanford, BHA
• Denice A. Blefgen McPherson, PT
• Jerry Blehm
• John Paul Block, M.D.
• Nathan Block
• John H Bocachica, MD
• Marilyn D Boggs, LPN
• Paul Samuel Boggs
• Thomas Bennett Bornstein, D.D.S.
• Andrea M Borny, RN, BSN

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Juneau, AK
• Providers in Juneau, AK by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.