Northern Living Center LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

NORTHERN LIVING CENTER LLC

Practice address

2795 W Stonebridge Dr
Wasilla, AK 99654-0742

Phone

(907) 376-5828

NPI assigned

Mar 24, 2023

Organization subpart

No

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

Authorized official

Name

Cory Detty

Title

Member

Phone

(404) 944-0041

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1073216438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 243162",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995243162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 W STONEBRIDGE DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996540742",
            "telephone_number": "907-376-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LIVING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "DETTY",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "404-944-0041"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Norris
• Samantha Jennings Norris, RBT
• Northern Dentistry Inc.
• Northern Edge Physical Therapy Limited Partnership
• Northern Edge Physical Therapy LLC (Northern Edge Physical Therapy)
• Northern Living Centers, LLC
• Northern Living Centers, LLC
• Northern Neurology, LLC
• Northern Orthopedics Inc (Hanger Clinic)
• Northern Psychiatry, LLC

• Assisted Living Facility in Wasilla, AK
• Providers in Wasilla, 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 Mar 24, 2023; 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.