Kaliedoscope Assisted Living Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

100372 Issued in AK

Legal business name

KALIEDOSCOPE ASSISTED LIVING HOME

Practice address

1331 Mission Rd
Kodiak, AK 99615-6583

Phone

(907) 486-8186

Fax

(907) 486-6260

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Terra L Cupp, CNA

Title

Administrator

Phone

(907) 486-8186

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1033258280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3923",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996153923",
            "telephone_number": "907-486-8186",
            "fax_number": "907-486-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 MISSION RD",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156583",
            "telephone_number": "907-486-8186",
            "fax_number": "907-486-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALIEDOSCOPE ASSISTED LIVING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "CUPP",
        "authorized_official_first_name": "TERRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-486-8186",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "100372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shana J Jones, RN
• Phillip Anthony Jordinelli, CDCS, NCACI, SAP
• Carolyn Judd, LMT
• Carol Juergens, MD
• Julie Kaiser, BHA-I
• Marita - Kaplan
• Kimberly Katelnikoff
• Margaret Kavanaugh
• Kennith E McCarty (Ken McCarty, LMFT Discovery Cove Recovery & Wellness Center)
• Samuel Frank Kenoyer

• Assisted Living Facility in Kodiak, AK
• Providers in Kodiak, AK by specialty
• Assisted Living Facility in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.