Active NPI
Northstar Assisted Living, Inc.
Doing business as Ruthies Assisted Living
- Assisted Living Facility
- Wasilla, AK
National Provider Identifier
1215061205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 000093
- Legal business name
- NORTHSTAR ASSISTED LIVING, INC.
- Doing business as
- Ruthies Assisted Living
- Practice address
- 4070 S Birch Cove Dr
Wasilla, AK 99654-9456 - Phone
- (907) 357-2019
- NPI assigned
- Mar 14, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Michael Allen Hervey
- Title
- General Manager, President Ceo
- Phone
- (907) 357-2012
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 000093 | AK | Primary |
Addresses
Primary practice location
4070 S Birch Cove Dr
Wasilla, AK 99654-9456
Mailing address
PO Box 872889
Wasilla, AK 99687-2889
Phone (907) 357-2019
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RL 5642 | Medicaid | AK | |
| HC 5642 | Medicaid | AK |
Other names 1
- Ruthies Assisted Living
National Provider Directory
National Provider Directory- Tax ID family
- Northstar Assisted Living Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
dba The Homestead
- Assisted Living Facility
- Palmer, AK
- NPI 1124142328
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1215061205",
"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": "907-357-2019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4070 S BIRCH COVE DR",
"city": "WASILLA",
"state": "AK",
"postal_code": "996549456",
"telephone_number": "907-357-2019"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHSTAR ASSISTED LIVING, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-14",
"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": "GENERAL MANAGER, PRESIDENT 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": "000093",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RL 5642",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HC 5642",
"state": "AK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Ruthies Assisted Living",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wasilla, AK
Sources for this page
- 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.