Organization Active NPI

Kachemak Way Assisted Living, Inc.

  • Assisted Living Facility
  • Homer, AK
National Provider Identifier
1255457313
Registry record updated Apr 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
00138 Issued in AK
Legal business name
KACHEMAK WAY ASSISTED LIVING, INC.
Practice address
4201 Kachemak Way
Homer, AK 99603-7144
Phone
(907) 235-6327
Fax
(907) 235-6149
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2010

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

Authorized official

Name
Ruth E Babcock
Title
Administrator
Phone
(907) 235-6327

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 00138 AK Primary
Non-emergency Medical Transport (VAN) 343900000X 138 AK
Respite Care 385H00000X 138 AK

Addresses

Primary practice location

4201 Kachemak Way
Homer, AK 99603-7144

Mailing address

4201 Kachemak Way
Homer, AK 99603-7144
Phone (907) 235-6327

Other identifiers 1

IdentifierTypeStateIssuer
RL3539MedicaidAK

National Provider Directory

National Provider Directory

Locations

4201 Kachemak Way
Homer, AK 99603
Phone (907) 235-0114

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271116800000",
    "number": "1255457313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 KACHEMAK WAY",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037144",
            "telephone_number": "907-235-6327",
            "fax_number": "907-235-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 KACHEMAK WAY",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037144",
            "telephone_number": "907-235-6327",
            "fax_number": "907-235-6149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KACHEMAK WAY ASSISTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-04-13",
        "status": "A",
        "authorized_official_last_name": "BABCOCK",
        "authorized_official_first_name": "RUTH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-235-6327"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AK",
            "license": "00138",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AK",
            "license": "138",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "AK",
            "license": "138",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RL3539",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; 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.