Colony House Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

000604 Issued in AK

Legal business name

COLONY HOUSE INC.

Doing business as

Colony House

Practice address

2801 E Bogard Rd
Wasilla, AK 99654-6014

Phone

(907) 357-1850

Fax

(907) 373-1820

NPI assigned

Dec 26, 2017

Last updated

Dec 26, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathan Dahl

Title

Administrator

Phone

(907) 841-1217

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Colony House Doing business as

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514246400000",
    "number": "1215443379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 870469",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996870469",
            "telephone_number": "907-841-1217",
            "fax_number": "907-373-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 E BOGARD RD",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546014",
            "telephone_number": "907-357-1850",
            "fax_number": "907-373-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONY HOUSE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-26",
        "last_updated": "2017-12-26",
        "status": "A",
        "authorized_official_last_name": "DAHL",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-841-1217"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "000604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1581371",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colony House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Dec 26, 2017; 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.