Northstar Assisted Living, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

000260 Issued in AK

Legal business name

NORTHSTAR ASSISTED LIVING, INC.

Doing business as

The Homestead

Practice address

17635 Pine Needle Way
Palmer, AK 99645

Phone

(907) 745-9040

NPI assigned

Mar 16, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Allen Hervey

Title

President, General Manager, Ceo

Phone

(907) 357-2012

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Homestead Doing business as

Tax ID family

Northstar Assisted Living Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Northstar Assisted Living

  • Assisted Living Facility
  • Palmer, AK
  • NPI 1841324142
  NPD tax ID
• Northstar Assisted Living, Inc.

  • Assisted Living Facility
  • Wasilla, AK
  • NPI 1215061205
  NPD tax ID

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124142328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 872889",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996872889",
            "telephone_number": "907-357-2012",
            "fax_number": "907-357-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17635 PINE NEEDLE WAY",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "99645",
            "telephone_number": "907-745-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR ASSISTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERVEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT, GENERAL MANAGER, CEO",
        "authorized_official_telephone_number": "907-357-2012",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "000260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL56421",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC 56421",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Homestead",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Palmer, AK
• Providers in Palmer, 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 Aug 22, 2020; 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.